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Surprise! Formulary and Rx History Incomplete

posted Jan 7, 2012, 12:42 PM by Nelson King   [ updated Jan 11, 2012, 10:20 PM ]
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.