Perceptions of e-prescribing efficiencies and inefficiencies in ambulatory care.
BACKGROUND
Recent studies have demonstrated that e-prescribing takes longer than handwriting. Additional studies documenting the perceived efficiencies realized from e-prescribing from those who have implemented electronic prescribing are warranted.


METHODS
We used a mixed method study design. We report on qualitative date from 64 focus groups with clinicians and office staff from six US states. Participants used one of six e-prescribing software packages. Qualitative data from the focus groups (276 participants) were coded and analyzed using NVivo software. Quantitative data regarding perceived efficiencies were extracted from a survey of 157 clinicians using e-prescribing.


RESULTS
Perceptions of e-prescribing included 64% reporting e-prescribing as very efficient. The next closest method was computer generated fax and prescriptions in which ∼25% rated the method as very efficient. Improvements in workflow and record keeping were noted. Perceived efficiencies were realized by decreased errors, availability of formularies at the point of prescribing and refill processing. Perceived inefficiencies noted included the need for dual systems owing to regulations preventing e-prescribing of scheduled medications as well as those introduced with incorrect information on formularies, pharmacy used, and warnings.


CONCLUSIONS
Overwhelmingly, clinicians and their staff confirmed the perceived efficiencies realized with the adoption of e-prescribing. Perceived efficiencies were realized in knowing formularies, processing refills, and decreasing errors. Opportunities to improve efficiencies could be realized by assuring correct information in the system.
Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA 23298, USA. kllapane@vcu.edu
Kate L
KL
Lapane
Rochelle K
RK
Rosen
Catherine
C
Dubé
D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D004360:Drug Therapy, Computer-Assisted; D055695:Electronic Prescribing / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D050316:Medical Order Entry Systems; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*