| Meaningful use of electronic prescribing in 5 exemplar primary care practices. | |
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MedLine Citation:
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PMID: 21911757 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Successful use of electronic prescribing (e-prescribing) is a key requirement for demonstrating meaningful use of electronic health records to qualify for federal incentives. Currently, many physicians who implement e-prescribing fail to make substantial use of these systems, and little is known about factors contributing to successful e-prescribing use. The objective of this study was to identify successful implementation and use techniques. METHODS: We conducted a multimethod qualitative case study of 5 ambulatory primary care practices identified as exemplars of effective e-prescribing. The practices were identified by a group of e-prescribing experts. Field researchers conducted in-depth interviews and observed prescription-related workflow in these practices. RESULTS: In these exemplar practices, successful use of e-prescribing required practice transformation. Practice members reported extensive efforts to redesign work processes to take advantage of e-prescribing capabilities and to create specific e-prescribing protocols to distribute prescription-related work among practice team members. These practices had substantial resources to support e-prescribing use, including local physician champions, ongoing training for practice members, and continuous on-site technical support. Practices faced considerable challenges during use of e-prescribing, however, deriving from problems coordinating new work processes with pharmacies and ineffective health information exchange that required workarounds to ensure the completeness of patient medical records. CONCLUSIONS: More widespread implementation and effective use of e-prescribing in ambulatory care settings will require practice transformation efforts that focus on work process redesign while being attentive to effects on patient and pharmacy involvement in prescribing. Improved health information exchange is required to fully realize expected quality, safety, and efficiency gains of e-prescribing. |
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Authors:
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Jesse C Crosson; Rebecca S Etz; Shinyi Wu; Susan G Straus; David Eisenman; Douglas S Bell |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Annals of family medicine Volume: 9 ISSN: 1544-1717 ISO Abbreviation: Ann Fam Med Publication Date: 2011 Sep-Oct |
Date Detail:
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Created Date: 2011-09-13 Completed Date: 2012-02-03 Revised Date: 2012-03-01 |
Medline Journal Info:
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Nlm Unique ID: 101167762 Medline TA: Ann Fam Med Country: United States |
Other Details:
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Languages: eng Pagination: 392-7 Citation Subset: IM |
Affiliation:
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Research Division, Department of Family Medicine and Community Health, UMDNJ-Robert Wood Johnson Medical School, Somerset, New Jersey 08873, USA. jesse.crosson@umdnj.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ambulatory Care Information Systems* Drug Prescriptions Electronic Health Records Electronic Prescribing* Humans Interviews as Topic Office Management / organization & administration* Primary Health Care / organization & administration* Systems Integration Workflow |
| Grant Support | |
ID/Acronym/Agency:
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1 U18 HS016391-01/HS/AHRQ HHS; HHSA290200600017//PHS HHS |
| Comments/Corrections | |
Comment In:
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Ann Fam Med. 2011 Sep-Oct;9(5):388-9
[PMID:
21911755
]
Ann Fam Med. 2011 Sep-Oct;9(5):390-1 [PMID: 21911756 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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