Cardiovascular specialists make gains in e-prescribing

Cardiologists, like physicians in general, haven’t fully embraced e-prescribing, but a study found the specialty is ahead of the pack in ownership and use of computerized prescription systems.

Electronic prescribing is expected to improve efficiencies and reduce preventable adverse drug events, Erik W. J. Kokkonen, MD, of Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues wrote in the November/December issue of the American Journal of Pharmacy Benefits. But those benefits depend on uptake by the physicians who prescribe medications.

The researchers analyzed 2007 to 2010 data from the National Ambulatory Medical Care Survey, a survey of physician practices that included two questions about e-prescribing. Respondents were asked to assess their computerized systems for e-prescribing and whether the system was used for that purpose.

Overall, ownership of a computerized prescription system increased from 29.9 percent in 2007 to 56.4 percent in 2010. Physicians who specialized in cardiovascular disease had higher than average unadjusted rates for both years, starting at 43.4 percent and jumping to 64.9 percent.

General and family medicine topped the list in 2010, with an ownership rate of 68.4 percent, followed by urology at 65.5 percent and then cardiovascular disease. Psychiatry posted the lowest rate, at 31.5 percent.

The practices that owned computerized prescription systems stepped up their use between 2007 and 2010, but not uniformly. Seven specialties, including cardiology, significantly increased their e-prescribing. Seven other specialties made little progress.   

Overall, the proportion of practices with a computerized system that sent prescriptions electronically rose from 62.2 percent in 2007 to 85.1 percent in 2010. The 2010 rate for cardiovascular disease totaled 91.5 percent. Only urology and internal medicine had higher rates, at 94.4 percent and 92.2 percent, respectively.

Trends are generally positive but there is room for improvement in adoption, Kokkonen and colleagues wrote. “Decisions on whether to adopt e-prescribing systems may be made by administrators of large health systems, and some physicians may not want to adopt e-prescribing immediately,” they proposed. “In addition, e-prescribing capabilities may be included as part of electronic medical record systems, so a physician may have access to but not use the e-prescribing feature.”

They added that the study period captured only the beginning of meaningful use incentives and consequently their analysis did not reflect the full effect of the program.