Still, Lakritz and his three-physician e- practice made the e-prescribing leap about five years ago, using a stand-alone e-prescribing system that integrates hand-held PDAs to transmit the data. And today, he admits he’s gotten much faster at entering the data into the computer. “I’ve gotten really good, so it’s almost as short of a time as writing it on paper,” says Lakritz.

It’s this sort of adoption barrier that e-prescribing still faces, despite all its toted benefits of improving patient safety and reducing skyrocketing medication costs. Fewer than one in ten doctors have converted their charts to digital formats, despite incentives, which experts say are not enough to help skeptical clinicians believe that e-prescribing is really worth it. “As it stands now, the value of electronic prescribing to physicians depends on prescription rate as well as practice size,” says Erika S. Fishman, director of research at Manhattan Research. “Physicians writing a larger number of prescriptions will have a greater need to decrease pharmacy callbacks and prevent errors, while those in a larger practice will have an easier time spreading the cost over the multiple players. Again, the benefits of electronic prescribing are the most transparent to pharma, PBMs (Pharmacy Benefit Management companies), payers, and patients, while being the least clear to the physicians themselves.”

Will e-prescribing change the management of drug interactions? One study conducted at Good Samaritan Hospital Medical Center in New York, showed that a shift from handwritten to computer-generated prescriptions was associated with an increase of controlled substances – opiods and benzodiazepine prescriptions – given in the emergency room department. “Simple regulatory changes and lifting of barriers, such as the utilization of electronic prescriptions, can make significant changes to practice patterns and may change the way patients are treated,” the research authors wrote in a study published recently by the Academy Emergency Medicine journal.

In a small physician office, e-prescribing systems provide medication management process through drug utilization review (DUR) programs, which perform checks against the patient’s body weight and age for drug appropriateness and correct dosing, as well as warning against drug-to-drug and drug-allergy interactions, contraindications, adverse reactions, and duplicate therapies. E-prescribing software can also include such drug reference software programs as ePocrates Rx. Pro and the PDR (Physician Desk Reference).

With approximately 3 billion prescriptions written annually, which constitutes one of the largest paper-based processes in the United States, e-prescribing still faces some speed bumps. Independent pharmacies have been slow to retool computer systems; only nine state Medicaid programs have made prescription benefit data available to network prescribers; and small practices, short on resources, have lagged behind in digitizing prescriptions. Still, e-prescribing nearly tripled in 2009, up by 181 percent compared with the previous year, an increase triggered due to federal programs that encourage physicians to go paperless.

“E-prescribing has been shown to cut costs – most of the focus around e-prescribing has been patient safety,” says Rob Cronin of SureScripts-RxHub, operator of the country’s largest electronic prescribing network. “But, increasingly, it is clear that e-prescribing also lowers costs. In addition to helping physicians and pharmacists cut the time and money of handling all the paper work and phone associated with paper-based prescribing, new research shows savings to consumers thru generic substitution.”