Electronic prescribing adoption rates: Finds from the National Healthcare Quality & Disparities Reports

Research Objective: To present finding on Electronic Prescribing System adoption. Background: Health Information Technology (HIT) has the potential to improve several aspects of health care including patient safety to care coordination. The Health Information Technology for Economic and Clinical Health Act authorizes incentive payments to providers in an effort to increase rates of HIT adoption. Method: Data on electronic prescribing come from the National Healthcare Quality and Disparities Reports, which compiled information from the National Ambulatory Medical Care Survey Electronic Medical Records Supplement and the American Hospital Association Information Technology Supplement. Stratified variables used in the analyses include metropolitan status, geographic region, practice size, physician's age, hospital size, Council of Teaching Hospital (COTH) membership and hospital control. Findings: In 2009, practices with 11+ physicians and in the West were more likely to have computerized systems for ordering prescriptions, sending prescription electronically, and warning of drug interactions or contraindications. Office-based physicians ages 35-44 had the highest percentage of adoption of these HIT functions. In 2008, 40% of hospitals with >400 beds but only 17.5% of hospitals with <100 beds had fully implemented electronic systems for drug decision support. Federal hospitals had a much higher percentage of full implementation of Computerized Physician Order Entry systems compared with investor-owned hospitals. Over 72% of members of COTH had fully implemented electronic systems for medication lists compared to 49% of non-COTH hospitals. Conclusion:Small ambulatory practices and small and for-profit hospitals have lower rates of electronic prescribing than larger facilities and federal hospitals. This lag in rates of adoption reflects the expense and major investment required. Young physicians are more likely to adopt electronic prescribing due to greater computer experience. Policies and incentives need to target training to older physicians and demonstrate not only gains in quality and safety but tin efficiency when e-prescribing is adopted.