The Impact of Technology Failure on Electronic Prescribing Behavior in Primary Care: A Case Study

  • Yi-Chin Kato-Lin
  • Rema PadmanEmail author
  • Keith T. Kanel
  • Toni Fera
Part of the Annals of Information Systems book series (AOIS, volume 19)


Electronic Prescribing (e-Rx) has significant potential to improve quality of care and reduce medication errors. However, its adoption rate in primary care has been slow for a variety of reasons. We examine the adverse impact of an information technology (IT) failure on the prescribing process as a critical reliability barrier to adoption. Data from Allscripts TouchWorks® database containing prescriptions written by six physicians in two primary care settings were analyzed using a statistical change-point detection algorithm to identify the tipping point in actual usage and subsequent trends in usage behavior. Physicians overwhelmingly switched from electronic transmission of prescriptions to print option in the presence of such a failure. We propose an approach for a control system that will allow for early detection of system failures and rapid process improvement, and discuss implications for handling such failures in the rapidly evolving IT-enabled healthcare delivery context.


Electronic prescribing Reliability of information technology Change point detection CUSUM control chart 



This research was supported in part by a grant from the University of Pittsburgh Medical Center eRecord program. We thank Dr. C. Shalizi of Carnegie Mellon University and Dr. W. Vogt of University of Georgia for valuable suggestions on the analytical models used in this paper and Allscripts® for providing us with the de-identified prescription data analyzed in this study. We are also grateful to the clinicians and staff of the two medical practices for participating in this study through interviews, feedback, and data.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Yi-Chin Kato-Lin
    • 1
  • Rema Padman
    • 2
    Email author
  • Keith T. Kanel
    • 3
  • Toni Fera
    • 4
  1. 1.Frank G. Zarb School of Business, Hofstra UniversityHempsteadUSA
  2. 2.The H. John Heinz III College, Carnegie Mellon UniversityPittsburghUSA
  3. 3.Pittsburgh Regional Health InitiativePittsburghUSA
  4. 4.Independent Healthcare ConsultantPittsburghUSA

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