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e-Prescribing for physicians doesn't have to be difficult

October 31, 2011
by Harrison White, LCSW, CPHIT, CPEHR
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Sometimes, it takes a little help from a trusted friend

Electronic prescribing, also known as e-Prescribing, is a software application that enables prescribers (usually physicians) to complete, transmit, and store prescriptions electronically. 1 e-Prescribing is reported to reduce medication errors, improve physician efficiency, improve quality of care and even reduce healthcare costs. 

Thanks to Meaningful Use incentives, virtually all prescribers (and sometimes, the organizations that employ them) may benefit from government-administered incentive payments as “eligible providers” when they adopt e-Prescribing as part of purchasing, implementing, and “meaningfully using” a complete, “certified” electronic health records system (EHR) according to evolving technology standards from the Office of the National Coordinator for Health Information Technology.2

One might imagine that with all of the potential benefits of e-Prescribing, physicians would embrace it and jump at the opportunity to benefit. However, it is clear that there's plenty of work to do to convince physicians that e-Prescribing is beneficial. Studies indicate multiple barriers that impede physician use.3

While the design and capabilities of an e-Prescribing application can play important roles in the acceptance of e-Prescribing, the real key to getting physicians to adopt it is to build, and then build upon, a good working relationship with the physician.

This relationship must begin with the reality that a physician's world is awfully busy, full of ever-increasing responsibility and accountability, as well as an all-important commitment to quality patient care. Therefore, at the start, it's important to have a realistic expectation about how much time any physician will have to learn a new e-Prescribing application.

Health IT professionals understand the importance of communicating, getting “buy in,” and developing a sense of anticipation around an IT project. Creating teams, scheduling meetings, and sending progress-related emails, followed perhaps by product demonstrations are common methods to communicate about an evolving IT project with end-users. At least, most end-users.

But physicians are often different. Is it realistic to expect that physicians are going to spend an hour exploring an e-Prescribing demo application and typing a return email with comments? Or, is it more realistic to:

  • request time for a five-minute introduction to e-Prescribing

  • promise a brief, guided demonstration with a one-page, bullet-listed summary of key features and use instructions

  • ask about the best time to contact/confirm the demonstration appointment and the preferred method of contact?

It is during these brief, businesslike exchanges that noting, and promising to demonstrate, the application's benefits becomes so important.

Nurses are invaluable as prescribing agents within the e-Prescribing system and play a critical role in how the physician experiences the e-Prescribing process. Of course, physicians are accustomed to partnering with nurses to complete tasks, so an ideal training schedule would involve training nurses first, then assigning them to buddy with physicians until the physicians feel comfortable with completing electronic medication orders.

4 keys to adopting e-Prescribing

  1. Build, or build on, a strong relationship

  2. Set realistic expectations for available training time

  3. Make nursing a lead partner in physician training

  4. Make training flexible in format, timing, and approach

 

This approach can be very effective for training and supporting physicians because it builds on an established and trusted relationship.

Other physician training support suggestions include: providing a brief, task-focused demonstration of the e-Prescribing application using task specific screen shots and an overall process flow. Such a demo must be brief, yet presented in a way that captures key actions and benefits without an excess of detail. Task-specific screen shots and process flows are a great takeaway for physicians, either as future reference or as a substitute for a live demo when physician time is extremely limited.

Physician application training needs to be flexible. Ideally, it should be available in several convenient ways, including by appointment, informally when needed, or on-demand. And, while understanding the complete functionality of the application is the ultimate goal, “scenario-based” training, built around successful use in common situations, can also be a very effective physician training strategy.

“Physician application training needs to be flexible. Ideally, it should be available in several convenient ways…”

As facilitators of the medical process, physicians are accustomed to being viewed as experts, but learning a software application moves them outside of that comfortable role. The discomfort they sometimes feel can be interpreted by some as resistance when it's not resistance at all.

To minimize such discomfort and facilitate adoption, consider providing application training on a one-on-one basis, built on an existing relationship. When you show a physician that you care about his or her needs, he or she will know that you have put them in the best position possible to learn the application and use it successfully. And to me, that's the key to successful adoption.

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