Government Trying to Speed Up Switch to Electronic Prescriptions

Medicare is offering doctors in South Carolina and across the country bonuses to get them to stop writing prescriptions by hand. Instead, the federal government wants doctors to use computer software that creates and sends electronic prescriptions directly to pharmacies.

E-prescribing eliminates one of the biggest problems pharmacists face: trying to read doctors' handwriting. "Sometimes it's pretty difficult, and we spend a lot of time trying to clarify, especially a physician's signature," says Lynn Connelly, a Columbia pharmacist. "Most of the time we can read the drug names pretty well. But if we've got a question, we have to pick up the phone, give 'em a call."

U.S. Department of Health and Human Services secretary Mike Leavitt says one study found that pharmacists make more than 150 million phone calls each year to doctors to clarify what's written on a prescription. But mistakes still happen. According to the Institute of Medicine, more than 1.5 million Americans are injured each year by prescription errors. The National Association of Boards of Pharmacy says about 7,000 people die every year because of those mistakes.

That's why Medicare will pay doctors a bonus of 2 percent in addition to their normal fee in 2009 and 2010. The bonus drops to 1 percent in 2011 and 2012 and to one-half percent in 2013. But doctors who don't start e-prescribing by 2012 will have their payments reduced.

Columbia physician Dr. Jimmy Williams has been e-prescribing for about two months already and thinks the move to it will have a huge impact. "It can save many lives. There are literally thousands of deaths per year for prescription errors, whether in the hospital or at the pharmacy; patients getting the wrong drug, getting the wrong dose, mainly because of handwriting. Unfortunately, doctors are famous for that" bad handwriting, he says.

Not only does e-prescribing eliminate handwriting, the software immediately warns the doctor if a drug he's about to prescribe will have a bad interaction with another drug the patient is already taking. Pharmacists can also check for drug interactions, correct dosages, allergies and contraindications.

Steve Hamilton, a patient seeing Dr. Williams Wednesday, says, as a patient, he appreciates e-prescribing. "You go to the doctor, and then, when you swing by the pharmacy, your prescription's already ready and it's already checking against other medicines you're already taking, or have taken, to see if there would be any kind of inter-reaction with it," he says.

One of the reasons some doctors have been reluctant to make the switch, and why Medicare is offering bonuses, is the cost. The electronic prescription software costs doctors about $3,000. Dr. Williams says, "Once you overcome that, the safety factors and the time-saving overall, it pays for itself, ultimately."