Determinants of physician use of an ambulatory prescription expert system

• HIT Description: Decision support, Electronic prescribing More info...
  
• Purpose of Study: To determine whether MD experience with and attitude towards computers is associated with adoption of ambulatory prescription writing system
  
• Years of study: 2003-2004
  
• Study Design: Cross-sectional
  
• Outcomes: Impact on patient satisfaction, impact on efficiency, utilization, and costs
  

• Settings: Academic internal medicine residency training clinic serving a predominantly indigent population in central Virginia.
• Intervention: Installation of an electronic prescription writing system
• Evaluation Method: Attitude and behavior survey conducted six months after implementation. In addition, system use was tracked.
• Description: Commercially available prescription expert system called Practice Partner version 7.5 enabled electronic maintenance of a medication list, printing and renewing prescriptions, and checking of drug-drug and drug-allergy interactions.
• Strategy: use was encouraged but not mandated
• System Penetration: 72% of MDs reported predominant usage (>=50% of prescriptions). Self-reported and measure technology use were highly correlated.
• Barriers: Electronic prescribing was more time consuming. Some felt their patients preferred hand-written prescriptions.
• Quality of Care and Patient Safety Outcome: On a 5-point scale, the system's effect on quality was rated 4.6 by MD users.
• Changes in efficiency and productivity: 57% felt that the system took more time than writing prescriptions by hand. However, 88% felt that the system would take less time after the patient medication lists were entered in the near future.