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E-prescribing: Derms relate benefits, pitfalls of emerging technology


With the appropriate software, electronic medical record (EMR) systems will enable physicians to e-prescribe medications and send them directly to the pharmacy before patients leave the exam room.

Key Points

Doctors who e-prescribe for 50 percent of their eligible patients and document that under the federal guidelines will receive a 2 percent bonus on their Medicare reimbursements in 2009 and 2010. That bonus decreases a half-percentage point annually, and then it converts to penalties for those who don't e-prescribe.

On Call checked with several dermatologists to see if they are e-prescribing and to determine whether they had concerns about the switchover.

Differing opinions

Inderjit K. Gill, M.D., F.A.A.D., a group practitioner in Hoffman Estates, Ill., says that while her office doesn't e-prescribe, she did some e-prescribing during residency.

Dr. Gill says she doesn't expect benefits to come without effort.

"It will make prescriptions clearer, decrease the chance of errors and improve communication with pharmacies," she says.

In Golden, Colo., Kira R. Giovanielli, M.D., F.A.A.D., says her practice is probably less than one year away from starting e-prescriptions. However, she adds, she's already running into complications that have nothing to do with the technology.

"A lot of our patients don't know which pharmacy they want to use. They tell me they'll get it filled somewhere on the way home. We haven't pushed it because we aren't quite ready.

"The pharmacies aren't ready, either, so we figure we'll wait until we are ready. Then, we'll probably just have to implement it and have a backup system for patients who don't know where they're going," Dr. Giovanielli tells Dermatology Times.

In practice for four years, Dr. Giovanielli admits she's a bit skeptical.

"I was a hand-written prescription person until two years ago; then, we got the EMR and print them off now. But even that step slowed me down significantly.

"It's good in a way - obviously, prescriptions are legible, and we don't get calls from the pharmacy asking questions, plus we have a nice computer record - but I'm hesitant to make it even more complicated.

EMR shortcomings add to Dr. Giovanielli's hesitancy to jump into the new technology.

"Our system has a lot of glitches that really cut down on efficiency. One example is that if I put in the word methotrexate, the system automatically adds the word 'inject.' You can't make it not do that, so you have to go back and delete it. Our sales rep says the next version will fix that, but it seems there is always something else," she says.

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