Implementing an electronic prescribing system

This is the personal experience of electronic prescribing (e-prescribing) implementation presented by Cindy Maddox, MD, FACS, director of glaucoma services and vice chairwoman at the New England Eye Center, Tufts University School of Medicine, Boston and member of the American Academy of Ophthalmology's health policy committee.

“[Zix Corp]” actually came to our practice. They initiated a wifi system that connected to a desktop software program, and they provided all of the physicians who were interested in doing e-prescribing with a handheld PDA that was compatible with this wifi system,” said Dr. Maddox.

That system is now antiquated because a lot of systems work through web browser technology with the PDAs.

First step

You have to set up software on your computer desktop, and you have to have some sort of device if you’re going to do it without an electronic medical record (EMR). “We don’t have EMR. There are many EMR systems that do integrate with e-prescribing,” said Dr. Maddox.

Creating a list of favorites

A list has to be made of your favorite prescriptions.

“This takes a lot of time, probably a good 4 to 6 hours of computer time. The advantage on the other end is that is it will be faster,” said Dr. Maddox. Dr. Maddox sees 150 to 175 patients a week and most are glaucoma patients. She said she e-prescribes for two-thirds of those patients.

Putting patient info in the e-prescribing system

Most vendors do interact with your patient information system. “They have a system at the beginning that will do a data download dump from the…[billing] system into the e-prescribing system that you’re going to use,” said Dr. Maddox. “That gets the patient’s name, demographics, and insurance information.”

You are starting with a volume of patients who are established patients. After that, each new patient that comes into the office has to be put into the system. That can be done manually with your reception or billing system.

Collect information about the patient’s preferred pharmacy

Collecting the patient’s preferred pharmacy information has to be done before you can do an e-prescribe.

“We send out a form that the patients either fill out ahead of time or when they are waiting in the office,” said Dr. Maddox. “It goes to the front desk people, the front desk people enter it into the system, by the time you see the patient that day it will have been entered into the system.”

Time consuming during your clinic day

Dr Maddox said, it’s not terrible, but it’s enough to have your technician with you to be assigned to this task to get the e-prescribing setup started on your PDA. “They can bring up the patient that you’re seeing, ask the patient if they need refills, and start using your favorites list,” said Dr. Maddox.

Response from patients

"The response from patients has been amazingly good," she said. "Patients absolutely love the concept that they don't have to now get a piece of paper from you.

"What I like about it is that I know that prescription has now gone to the pharmacy. I know that even though my patient might forget that they need their medication, chances are, their pharmacy is going to contact them.”