The Crosson et al (2012) study just published in The Journal of the American Board of Family Medicine reinforces what has been known for some time. E-prescribers continue having trust issues with electronic formulary checks and electronic medication histories. Why would an e-prescriber spend the time checking an unreliable e-formulary if the pharmacy must do so anyway for adjudication? How do you trust the completeness of a medication history (from claims database) when many filled prescriptions may not appear (e.g., paying cash for $4 generic at Target rather than $25 for same generic via insurance coverage). The authors point out pharmacy sales data might be a better alternative. Even if the information were available, there are issues with secondary use of pharmacy sales data that need to be addressed.
The premise of e-prescribing is that increasing the ease of information access enables collaboration in this inter-organizational network. Information integrity has been a known problem in inter-organizational environments as the importance of controlling integrity via the infrastructure has not been appreciated (Wilkin and Chenhall, 2010). There are no easy solutions but a meaningful dialogue must begin. The prescribers do want this information (Lapane et al, 2011).
CROSSON J C, SCHUETH A J, ISAACSON N and BELL D S (2012) Early adopters of electronic prescribing struggle to make meaningful use of formulary checks and medication history documentation. The Journal of the American Board of Family Medicine 25(1), 24-32.
LAPANE K L, WARING M E, DUBÉ C E and SCHNEIDER K L (2011) E-prescribing and patient safety: Results from a mixed method study. The American Journal of Pharmacy Benefits 3(2), e24-e34.
WILKIN C L and CHENHALL R H (2010) A review of IT governance: A taxonomy to inform accounting information systems. Journal of Information Systems 24(2), 107-146.