Electronic prescription is a healthcare initiative that employs the use of computerized devices to modify, review, output and communicate drug prescriptions. The medical technology is implemented through different modes such as electronic reference books, stand-alone prescription writer, patient-specific prescription creation and refilling and medication management. Electronic prescription thus enhances access to medication history, warnings and alerts, dispensing sites’ connectivity and integration of medical records (Health Information Technology, 2014).
How Electronic Prescription Works
Electronic prescription is meant to facilitate the fastest communication between the prescriber, transaction hub and the pharmacist. In this case, the prescriber is the physician who has the initial interaction with the patient hence identifies the patient’s record by logging in retrieving the profile of the patients into the e-prescription system. In a more sophisticated and comprehensive system, the e-prescription system should display all the records pertaining patient’s medical history. The physician reviews the history and makes the most relevant prescription before sending the information to the transaction hub (Kierkegaard, 2013).
Transaction hub connects the prescriber and pharmaceutical manager and the pharmacy. The system verifies the information of patient’s eligibility and medication history by sending the information back to the prescriber. The prescriber authorizes the prescription by attaching an electronic signature before transmitting it to the pharmacy. The pharmacist then dispenses the drugs to the patient and communicates back to the transaction hub. The message is finally transmitted to the prescriber as affirmation that the patient has been issued with the drug within the stipulated time (A clinician's guide to electronic prescribing, 2011).
Stand-alone system and EHR are the most applicable electronic prescription systems. The former facilitates e- prescription by providing patient storage and management data which includes medical history, medication allergies and other relevant information. These are downloaded through a software package or connected through the Internet. The latter is more comprehensive hence incorporates immediate diagnosis, problem lists, and laboratory and radiology results of a particular patient. The technology also offers clinical decision supports such as recommended screening and immunization (A clinician's guide to electronic prescribing, 2011).
Advantages of Electronic Prescription
Electronic prescription has been preferred by many healthcare systems due to a number of advantages associated with the technology. To begin with, e-prescription improves patient safety and safety of healthcare. It achieves this by reducing illegibility errors associated with handwritten prescriptions and oral communications. It also makes patient’s medical history accessible and accurate and enhances efficiency in warning and alert systems (A clinician's guide to electronic prescribing, 2011).
Electronic prescription also reduces time wastage that is experienced in making calls and call backs to the pharmacies. The technology replaces the old formula that had to involve several telephone conversations regarding clarifications, inquiries, renewal requests, availability of drugs and drug instructions. It thus makes the pharmacy more efficient as the technologist accesses all necessary information online hence does not experience divided attention in responding to calls (Kierkegaard, 2013).
Electronic prescription also reduces the cost incurred during the prescription process. For instance, it saves resources that could have been spent in faxing and paper that are useful in manual prescriptions. The technology also automates prescription renewal request and authorization process. In case of unavailability of a prescribed drug in a pharmacy, the technologist can quickly send a renewal request to the prescriber who responds instantly by approving or denying the renewal. It makes the authorization and renewal task very efficient for both the pharmacist and the physician (Clinician’s guide to electronic prescribing, 2008).
Electronic prescription also increases patient convenience and medication compliance. A good illustration is the observation that some paper-based manual prescriptions often go unfilled due to the hassle associated with dropping the paper, queuing and waiting. The technology also enhances greater prescriber mobility and convenience. It is based on the fact that electronic prescription is done through mobile electronic devices such as laptop and PDA, making it possible for doctors to make prescriptions anywhere even outside their office premises. It has also been noticed that e-prescription improves drug surveillance ability. For instance, the system avails automated analytical quarries and reports which are hard to access through the paper prescription system (Clinician’s guide to electronic prescribing, 2008).
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Challenges Associated With Electronic Prescription
Although many physicians advocate transition from paper to electronic prescription, a new technology is associated with a number of challenges. For instance, some physicians have always felt that unnecessary stakeholders who are not members of the medical profession are incorporated into the system hence unfairly benefit from their share. It has also been observed that some IT experts utilize this opportunity to exploit the physicians by imposing on them high costs for installation, management, customization, maintenance and upgrading of e-prescription systems (Ducker, Sanchez, & Taylor, 2013).
Electronic prescription is also challenged in issuing of controlled drug substances. In America, there is evidence that at least 20% of all prescriptions issued by doctors are controlled substances. According to the law, such substances must only be issued on the evidence of written prescription, printed and manually signed by a medical practitioner. The mixed system makes the prescription exercise more complicated as the pharmacies have to adopt different workflows to manage these prescriptions. In other cases, individual states hold different policies regarding the electronic prescription. For instance, Medicaid in New York State still holds to the “dispense as written” policy which believes in the handwritten prescription as the doctor’s acceptable authority (Ducker, Sanchez, & Taylor, 2013).
In addition to these, hardware and software selections expose the physicians to critical challenges. Some doctors still struggle in selecting, negotiating and implementing the most ideal e-prescription program. Besides these, many pharmacies are not subscribed into the mail order connectivity. By 2008, it was noted that approximately 73% of independent pharmacies were not connected to e-prescription system. Although positive advancements have been made, many subscribed pharmacies are still unwilling to use the system for the fear of the payable fee for every electrically prescribed drug (E-Prescribing, 2011).
The technology also has challenges associated with the transition from manual to electronic prescription system. Consequently it has become challenging to retrieve all the manual data of the previously used drugs by a particular patient. The doctors, therefore, have to rely on information given by the patient which is fed into a computer system and may not be very accurate. The transition from manual to e-prescription is thus marked by a number of discrepancies (E-Prescribing, 2011).
Electronic prescribing is also limited in accessing remote areas. It is based on the fact that many rural areas still lack consistency in digital services and broadband Internet services. Besides these, some patients may oppose the idea and insist on carrying a paper prescription. It seems more convenient for patients who often travel long distances for extended periods as they are likely to be serviced beyond the e-prescription networks (E-Prescribing, 2011).
E-prescription system has been preferred by clinicians as a means of enhancing accuracy, efficiency, safety and compliance in medical services. However, it is associated to a number of challenges which hail from state’s regulatory standards, restrictions regarding controlled substances, accessibility in rural areas, patients’ compliance, installation and maintenance costs.