The Pros and Cons of E-Prescribing

E-prescribing is the means of transmitting a prescription or prescription-related information between a prescriber or dispenser in an electronic format either directly or through an e-prescribing network. The prescriber refers to physicians, physician assistants, or other licensed or registered professional permitted to issue prescription drugs or products. The dispenser refers to the pharmacist or other licensed or registered professional permitted to provide prescription drugs or products.

Transactions that are considered to be referred to as e-prescribing include:

  • New Prescriptions
  • Refills
  • Changes
  • Cancellations

The inclusion of electronic prescribing in the Medicare Modernization Act (MMA) of 2003 gave momentum to the movement, and the July 2006 Institute of Medicine report on the role of e-prescribing in reducing medication errors received widespread publicity, helping to build awareness of e-prescribing's role in enhancing patient safety. Adopting the standards to facilitate e-prescribing is one of the key action items in the government's plan to expedite the adoption of electronic medical records and build a national electronic health information infrastructure in the United States.


Qualifying Features

According to the E-Prescribing Incentive Program, a qualified e-prescribing system is one that is capable of ALL of the following: 

  • Generate a complete active medication list incorporating electronic data received from applicable pharmacies and pharmacy benefit managers (PBMs) (if available)
  • Select medications, print prescriptions, electronically transmit prescriptions, and conduct all alerts (including automated prompts)
  • Provide information related to lower cost, therapeutically appropriate alternatives
  • Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan
  • Meet specifications for messaging


The costs of implementing an e-prescribing system for the medical office will vary based on the size and location. Before making the decision to install an e-prescribing system, several factors should be considered associated with cost. The purchase of equipment and software, the monthly fees, and ongoing maintenance or upgrades are just a few things to consider.


  • CMS may offset the cost through e-prescribing initiatives.
  • Can be included or added to an existing EMR system
  • Saves time in handling prescription refill requests which saves in staffing costs


  • Purchasing and installing a brand new system can be costly
  • Costs also include online fees and maintenance


Anytime a new system or process is implemented within the medical office, productivity can be affected. Some changes increase productivity or decrease productivity immediately or over a period of time while staff becomes acquainted or learns the new system. The biggest barrier may be the resistance to change by both the staff and physicians.


  • Instant connectivity to the pharmacy is faster than the traditional phone call
  • Decreases the time it takes to request medication refills
  • Increases the speed of pharmacy callbacks
  • Decreases the time it takes verify eligibility


  • May temporarily impact the medical office workflow
  • Installation may slow down current processes
  • Medical Office staff and physician training may slow down productivity


Many in the healthcare industry fail to realize that prescribing drugs is a legal issue. Considering the standards adopted by CMS, some practices in the medical office are now considered as noncompliant. In addition to the handwriting errors that can occur, transactions involving mix-ups or patient privacy breaches could all possibly fall in the legal category.


  • Eliminates handwriting mistakes
  • Reduces the risk of errors due to mix-ups that can happen over the phone
  • Some programs allow cross-checking against the electronic medical record to reduce adverse effects


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