E-prescribing a boon or a bane to dermatology practices?

Key Points

On Call wondered whether dermatologists are using e-prescriptions, and if so, whether they actually like them. We talked to dermatologists around the country and found a variety of opinions ranging from love to indifference to - well, it might not be quite hate, but a strong dislike for the process.

Some doctors say they've been using e-prescribing for years, while others have just a few months of experience with it, but that doesn't always seem to determine their opinions.

"We do use it at the Cleveland Clinic, not all the time, but we do use it - for refills, mainly. We don't use it more extensively because, although most of the pharmacies are in the system, often the patient doesn't know which pharmacy he uses. So that part of it is not in the record yet. Patients will also use different pharmacies at different times, so it's just not that easy."

Dr. Remzi isn't convinced that e-prescriptions are all that great, even when they do work.

"They're fine, but they don't really make my job any easier. There are still glitches, such as pharmacies claiming they never got the prescription we sent, so it doesn't solve all the problems," she says.

EMR issues

"E-prescriptions are great on the way out, but they make more work for me on the way back in. Through our EMR (electronic medical record) system, I can send prescriptions straight to the pharmacy. That's wonderful and patients like that.

"But then the pharmacies invariably have the option of sending refill requests back to me through the EMR. That's not something I like very much. The onus is then on me to do more. Before, when pharmacies called, they would be routed through the medical assistant. Now, the pharmacies require that the M.D. be on the other side of the e-script for refills," Dr. Buka says.

Dr. Buka, the section chief of dermatology for Mount Sinai School of Medicine, says that while he likes some aspects of e-prescribing, it's not perfect. "It's not the Shangri-La we all thought it would be. One thing I don't like is that when I print out scripts, I get to put final touches on them or make any adjustments I need to make. Maybe I'll put in the word 'back' or 'chest,' or I will double-check to make sure the strength is correct. When I submit the prescription by e-prescribing, I don't have that ability. It goes straight the pharmacy and I don't get that last look," he says.

To cope with that issue, Dr. Buka uses what he calls a "hybrid" system of faxing sometimes and printing others.