Some time ago we published a post about what's holding back electronic prescribing (e-prescribing) adoption in the U.S. primary care. Then I approached my LinkedIn connections and Intersog Twitter followers asking them to reflect on the article. See below what eHealth experts think about the challenges of e-prescribing adoption and reasons that prevent it from going mainstream in healthcare.
Internet entrepreneur and health IT blogger John Lynn says the majority of physicians have already started to e-prescribe and that trend will continue.
According to John, "ePrescribing of controlled substances has fallen behind with many physicians due to the regulations around controlled substances. It took years for the government to work out how they would handle ePrescribing of controlled substances. Because it took so long for the government to finalize and implement the rules and regulations around controlled substances, many doctors don't know that they can ePrescribe controlled substances. I believe that the biggest reason more controlled substances aren't ePrescribed is the lack of education. Most doctors would be happy to ePrescribe contolled substances the same way they do other medications, but they likely don't realize that it's allowed. Plus, now that most pharmacies support it, doctors can start to do it without any concerns that their pharmacy doesn't support it."
"E-prescreption was recently rolled out in Norway and my personal experience is that they are a tremendous improvement compared to the former analogous paradigm (I can text/call my physician and the prescription is available almost instantly)," says Carl Haakon Samuelson. "Today, approximately 80% of all prescriptions in Norway are electronic. I think the main concern is security; locally this is solved by having a closed loop health network (simple to achieve in Norway since most healthcare is publicly run and we have a small homogenous population). Secondly, a consent from the patient is required (the patient may accept or not the electronic prescriptions in accordance with their security preferences). In a global perspective, the infrastructure and high levels of fragmentation in who provides healthcare (insurance companies, NGOs, public sector, private clinics) are probably the largest barriers to e-prescriptions."
IT Systems Security Architect Lee Mathers believes there're 2 biggest impediments to e-prescribing adoption: access and control.
@_DigiHealth has pointed to 3 reasons:
1. Physicians are reluctant to adapt to the fast-growing health tech industry;
2. Healthcare is generally slow-moving compared to other tech-driven industries;
3. Legal restrictions.
Healthcare brand designer Argenis Carmona says many doctors are actually resistant to change and that's the key barrier to mass adoption of e-prescribing in healthcare.
Clint LeClair, MD, has left us the following answer in Quora:
"E-prescribing faces similar logistical impediments as phoning in a prescription. Writing by hand and giving the script to the patient puts the responsibility of filling it, with the myriad of navigating insurance coverage / pharmacy. Now for the big issue: security. The average physician still is wary of hacking- within their own personal system.
Now tell an average physician that you want them to trust their DEA number to a computer that will be sending that info out to pharmacies and most will only see another entry point for potential fraud. Paper scripts are designed with security in mind and are well understood by all authorized parties involved (DEA, FDA, physician, and pharmacy).
You are essentially asking the physician to take on risk that was already externalized and accepted as standard practice as being the patients' responsibility (and liability)."