title: Barriers to electronic prescribing: Nebraska pharmacists' perspective.
abstract: OBJECTIVE
  Electronic prescribing (e-prescribing) and its accompanying clinical decision support capabilities have been promoted as means for reducing medication errors and improving efficiency. The objectives of this study were to identify the barriers to adoption of e-prescribing among nonparticipating Nebraska pharmacies and to describe how the lack of pharmacy participation impacts the ability of physicians to meet meaningful use criteria.
  
  
  METHODS
  We interviewed pharmacists and/or managers from nonparticipating pharmacies to determine barriers to the adoption of e-prescribing. We used open-ended questions and a structured questionnaire to capture participants' responses.
  
  
  RESULTS
  Of the 23 participants, 10 (43%) reported plans to implement e-prescribing sometime in the future but delayed participation due to transaction fees and maintenance costs, as well as lack of demand from customers and prescribers to implement e-prescribing. Nine participants (39%) reported no intention to e-prescribe in the future, citing start-up costs for implementing e-prescribing, transaction fees and maintenance costs, happiness with the current system, and lack of understanding about e-prescribing's benefits and how to implement e-prescribing.
  
  
  CONCLUSIONS
  The barriers to e-prescribing identified by both late adopters and those not willing to accept e-prescriptions were similar and were mainly initial costs and transaction fees associated with each new prescription. For some rural pharmacies, not participating in e-prescribing may be a rational business decision. To increase participation, waiving or reimbursing transaction fees, based on demographic or financial characteristics of the pharmacy, may be warranted.
authors.affiliation: Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Lina
authors.initials: L
authors.lastname: Lander
authors.forename: Donald G
authors.initials: DG
authors.lastname: Klepser
authors.forename: Gary L
authors.initials: GL
authors.lastname: Cochran
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Lomelin
authors.forename: Marsha
authors.initials: M
authors.lastname: Morien
mesh_terms: D055695:Electronic Prescribing / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D009329:Nebraska; D010595:Pharmacists; D011795:Surveys and Questionnaires