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The Pros and Cons of E-Prescribing


E-prescribing is the means of transmitting a presciption or prescription-related information between a prescriber or dispenser, in an electronic format either direcly or through an e-prescribing network.  The prescriber refers to physicians, physician assistants or other licensed or registered professional permitted to issue prescription drugs or products.  The dispenser refers to the pharmacist or other licensed or registered professional permitted to provide prescription drugs or products.

Transactions that are considered to be referred to as e-prescribing include:

  1. New Prescriptions
  2. Refills
  3. Changes
  4. Cancellations

1. Qualifying Features

According to the E-Prescribing Incentive Program, a qualified e-prescribing system is one that is capable of ALL of the following: 

  • Generate a complete active medication list incorporating electronic data received from applicable pharmacies and pharmacy benefit managers (PBMs)(if available)
  • Select medications, print prescriptions, electronically transmit prescriptions, and conduct all alerts (including automated prompts)
  • Provide information related to lower cost, therapeutically appropriate alternatives
  • Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patients drug plan
  • Meet specifications for messaging

Information Obtained from CMS.gov

2. Costs

The costs of implementing an e-prescribing system for the medical office will vary based on the size and location. Before making the decision to install an e-prescribing system, several factors should be considered associated with cost. The purchase of equipment and software, the monthly fees, and ongoing maintainence or upgrades are just a few things to consider.  



  • Purchasing and installing a brand new system can be costly
  • Costs also include on-line fees and maintenance
  • Payments from CMS initiatives end 2013

3. Productivity

Anytime a new system or process is implemented within the Medical Office, productivity can be effected. Some changes increase productivity or decrease productivity immediately or over a period of time while staff becomes acquainted or learns the new system. The biggest barrier may be the resistance to change by both the staff and physicians.


  • Instant connectivity to the pharmacy is faster than the traditional phone call
  • Decreases the time it takes to request medication refills
  • Increases the speed of pharmacy callbacks
  • Decreases the time it takes verify eligibility


  • May temporarily impact the medical office workflow
  • Installation may slow down current processes
  • Medical Office staff and physician training may slow down productivity

4. Legal

Many in the health care industry fail to realize that prescribing drugs is a legal issue.  Considering the new standards adopted by CMS, some practices in the medical office are now considered as noncompliant.  In addition to the handwriting errors that can occur, transactions involving mixups or patient privacy breaches could all possibly fall in the legal category.


  • Eliminates handwriting mistakes
  • Reduces the risk of errors due to mix-ups that can happen over the phone
  • Some programs allow cross checking against the electronic medical record to reduce adverse effects



Eligible professionals may begin reporting the eRx measure at any time throughout the 2011 program year of January 1-December 31, 2011 to be incentive eligible, but must do so prior to June 30, 2011 to be exempt from the 2012 eRx payment adjustment (click on "Payment Adjustment" link on the left for more information. Click on the"Eligible Professional" link on the left to see if you are an eligible professional. Eligible professionals must have adopted a "qualified" eRx system in order to be able to report the eRx measure.  There are two types of systems. 

  1.  a system for eRx only (stand-alone)
  2. an electronic health record (EHR system) with eRx functionality.

Read more at http://www.cms.gov/ERxIncentive/03_How_To_Get_Started.asp#TopOfPage


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