Electronic prescribing (e-prescribing) is defined as the direct computer-to-computer transmission of prescriptions from prescriber offices to retail pharmacies.1
Electronic prescriptions (e-prescriptions) are generated within Computerized Physician Order Entry systems and are electronically transmitted to pharmacies via a secure electronic network between prescribers and pharmacies.2
e-Prescribing was initially intended to allow for medication orders to be received and processed electronically thereby completely eliminating the use of paper in the processing of prescriptions in pharmacies. The ultimate goal of implementing e-prescribing was to achieve the following: reduce medical errors, decrease pharmacy costs, improve both prescriber and pharmacy efficiency, eliminate handwriting interpretation errors, reduce phone calls between pharmacists and physicians, reduce data entry, and expedite prescription refill requests.3
Prior to the adoption of e-prescriptions, handwritten prescriptions were the primary means of communicating drug choice and therapy of a patient between prescribers and pharmacists. The hazards associated with poor handwritten prescriptions such as difficulties with readability, risk of misinterpretation and falsification of handwritten prescriptions prompted the adoption of e-prescriptions.4
Of all commonly used health information technology (HIT), e-prescribing has received the most attention for its potential to improve safety.5
e-Prescribing use is now being promoted as an integral component of HIT and has been mandated for use by all prescribers by federal government regulations on meaningful use of HIT. e-Prescribing use by prescribers and pharmacists is expected to improve the safety, quality and efficiency of patient care. It has also been speculated that e-prescribing use can improve patient satisfaction with care by reducing waiting time at the pharmacy.6
Since this mode of transmitting prescriptions has been mandated by the federal government, approximately 91% of retail pharmacies are now receiving e-prescriptions.7
The number of e-prescriptions received nationwide in retail pharmacies, such as Walgreens and Medicine Shoppe pharmacies, has rapidly increased. In 2010, over 320 million e-prescriptions were transmitted to pharmacies nationwide, while only 191 million prescriptions were received electronically in 2009, a 72% increase.8
Studies conducted with physicians who generate and transmit e-prescriptions to pharmacies have indicated that problems exist with e-prescribing systems due to poor implementation and usability of these systems.9
However, little is known about e-prescription processing in retail pharmacies.
Retail pharmacies have been the forerunners in the adoption of HIT, having adopted computer systems to manage patients' prescription profiles and electronic billing for prescriptions for over 3 decades.10
There is clear evidence that the usability of HIT is an important factor for meaningful use by all healthcare professionals affected by its adoption.11
Compared with hospitals, the usability of e-prescribing systems is rarely studied in retail pharmacies, the recipients of e-prescriptions. Studies have reported inconsistent results in explaining how e-prescribing affects the quality of patient care. One study reported that pharmacists perceived key weaknesses in how e-prescribing had been implemented in their organizations.12
Another study found that e-prescribing presented certain threats to safe dispensing of medications.13
These two studies examined e-prescribing technology when it was in its infancy and their evaluation was based on national chain pharmacies (such as Walgreens and CVS) and excluded independent pharmacies. Little is known about the extent to which the design of e-prescribing technology facilitates or hinders processing of prescriptions in pharmacies. To our knowledge, this is the first study to examine the design of e-prescribing in retail pharmacies.