This post is written by Denise Milestone, RN, of Parkview Health in Fort Wayne, Ind.

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In the last two years that e-prescribing has been used in my health system, Parkview Health in Fort Wayne, Ind., we’ve seen some major benefits, as well as overcome some challenges. The implementation process at Parkview was fairly straightforward. We started with a small group of physicians and nurses who were required to e-prescribe, and then we slowly added more practitioners to this group. We put out statistics on who was e-prescribing and how much and shared that with staff, so that physicians and nurses could see how they were doing compared to their peers. This did a lot to encourage adoption. Our staff seemed to pick it up most easily if they were younger and more computer savvy, but it was pretty simple for everyone to adopt. I would say it took about a month or two for everyone to get the hang of it.

I see the top three benefits of e-prescribing at Parkview as the following:

#3: E-prescribing cuts down on Parkview’s faxes and phone calls, both for the original prescription and for e-refills. We save on a lot of paper.

#2: Younger patients love it. It’s very convenient for them and they like not having to keep track of the prescription paper. But, it does seem like older patients miss having paper prescriptions and aren’t as comfortable with the idea of e-prescribing. We really have to educate not only the physicians and Parkview staff, but also the patients on the benefits of e-prescribing.

#1: Patient safety has improved. Not only is legibility addressed, but pharmacies are able to see in the system what drugs a patient is being prescribed and can make sure there aren’t any adverse events.

This is not to say e-prescribing is without challenges. In particular, we’ve had trouble adjusting prescriptions that start at one dose (like prescribing a patient a 20mg tablet twice/day) but then after a set period of time increase (like to a 40mg tablet once/day). Previously we have noted this clearly in the prescription area. Now, we have to add a comment in the notes section with instructions for the pharmacist, which occasionally causes confusion.

Also, because not all pharmacies are able to accept e-prescribing, there still some manual work that has to happen. Fortunately, our e-prescribing system knows which pharmacies cannot accept e-prescribing and will then revert to the old-fashioned way of faxing the prescription. This has definitely improved over the two years we’ve been e-prescribing -- more pharmacies than ever accept e-prescribing -- but there are still some that do not. It gets easier each year to e-prescribe.

Overall, the e-prescribing process was very easy to implement and its benefits have outweighed the minimal downsides we’ve experienced. We’re extremely happy e-prescribing, and so are our patients.

Has anyone else experienced the challenge with noting the dosages? How have you addressed?

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