Beyond the basics: Refills by electronic prescribing

Goldman, Roberta E.; Dubé, Catherine; Lapane, Kate L.

doi:10.1016/j.ijmedinf.2010.04.003

« Previous Next »International Journal of Medical Informatics
Volume 79, Issue 7 , Pages 507-514, July 2010

Beyond the basics: Refills by electronic prescribing

Roberta E. Goldman
- Brown University Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI 02860, United States
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Pawtucket, RI 02860, United States
Catherine Dubé
- Department of Community Health, Warren Alpert Medical School of Brown University, Providence, RI 02912, United States
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States
Kate L. Lapane
- Department of Community Health, Warren Alpert Medical School of Brown University, Providence, RI 02912, United States
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA 23298, United States
- Corresponding author at: Virginia Commonwealth University, Box 98012, 830 East Main Road, Richmond, VA 23298, United States. Tel.: +1 804 628 2506; fax: +1 804 828 9773.

Received 24 February 2010; received in revised form 16 April 2010; accepted 18 April 2010. published online 20 May 2010.

Abstract

Introduction

E-prescribing is part of a new generation of electronic solutions for the medical industry that may have great potential for improving work flow and communication between medical practices and pharmacies. In the US, it has been introduced with minimal monitoring of errors and general usability. This paper examines refill functionality in e-prescribing software.

Methods

A mixed method study including focus groups and surveys was conducted. Qualitative data were collected in on-site focus groups or individual interviews with clinicians and medical office staff at 64 physician office practices. Focus group participants described their experiences with the refill functionality of e-prescribing software, provided suggestions for improving it, and suggested improvements in office procedures and software functionality.

Results

Overall, ∼50% reduction in time spent each day on refills was reported. Overall reports of refill functionality were positive; but clinicians and staff identified numerous difficulties and glitches associated managing prescription refills. These glitches diminished over time. Benefits included time saved as well as patient convenience. Potential for refilling without thought because of the ease of use was noted. Clinicians and staff appreciated the ability to track whether patients are filling and refilling prescriptions.

Discussion

E-prescribing software for managing medication refills has not yet reached its full potential. To reduce work flow barriers and medication errors, software companies need to develop error reporting systems and response teams to deal effectively with problems experienced by users. Examining usability issues on both the medical office and pharmacy ends is required to identify the behavioral and cultural changes that accompany technological innovation and ease the transition to full use of e-prescribing software.

Keywords: Electronic prescribing, Computerized physician order entry, Alerts and reminders, Ambulatory care