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Uptake of Electronic Prescribing in Community-Based Practices

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Abstract

BACKGROUND

Electronic prescribing (e-prescribing) has the potential to improve the safety and efficiency of medication use, but uptake of e-prescribing in community-based settings has been limited to date. In April 2004, 2 large insurers in Massachusetts began a program to fund e-prescribing systems for targeted clinicians and practices. We studied the adoption and uptake of e-prescribing by the targeted prescribers.

METHODS

We obtained data on all e-prescriptions written from April 2004 to March 2005. We tabulated the number of clinicians using the e-prescribing system and the number of prescriptions written. We also obtained claims data from the 2 insurance companies and calculated the proportion of each clinician’s prescriptions that were written electronically. We developed multivariable models to estimate the impact of different clinician characteristics on the proportional rate of e-prescribing.

RESULTS

During the first 12 months of the e-prescribing program, 1,217 prescribers began using the e-prescribing system. In the final month of the study, over 55,000 e-prescriptions were written for patients covered by the 2 included insurance plans. The proportion of total reimbursed claims per clinician written electronically increased slowly during the study period and was still below 30% by the end of the study period. This number increased to 42% when we restricted the sample to medications normally used for acute indications. Multivariable models showed that younger clinicians, pediatricians, and prescribers in larger practices exhibited higher uptake rates as a proportion of total prescriptions.

CONCLUSIONS

Clinician use of e-prescribing increased steadily in the first 12 months of an initiative sponsoring e-prescribing systems. Uptake of e-prescribing was only partial, with younger clinicians and pediatricians more likely to use the system. Research to understand why prescribers vary in their use of e-prescribing and to develop techniques to encourage more wide-spread adoption will be an important priority for future studies.

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Acknowledgment

We gratefully acknowledge the assistance of BCBSMA, Tufts HP, and ZixCorp in providing data for this research. The investigators retained control over all aspects of the analyses and presentation of results. This research was supported by AHRQ grant R01 HS15175.

Conflict of Interest Statement

None disclosed.

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Authors and Affiliations

  1. Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Boston, MA, USA

    Michael A. Fischer MD, MS & Margaret R. Stedman MPH

  2. Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Christine Vogeli PhD, Timothy G. Ferris MD, MPH & Joel S. Weissman PhD

Authors
  1. Michael A. Fischer MD, MS
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  2. Christine Vogeli PhD
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  3. Margaret R. Stedman MPH
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  4. Timothy G. Ferris MD, MPH
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  5. Joel S. Weissman PhD
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Corresponding author

Correspondence to Michael A. Fischer MD, MS.

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Fischer, M.A., Vogeli, C., Stedman, M.R. et al. Uptake of Electronic Prescribing in Community-Based Practices. J GEN INTERN MED 23, 358–363 (2008). https://doi.org/10.1007/s11606-007-0383-1

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  • DOI: https://doi.org/10.1007/s11606-007-0383-1

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