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The American Journal of Managed Care September 2013
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Emerging and Encouraging Trends in E-Prescribing Adoption Among Providers and Pharmacies
Meghan H. Gabriel, PhD; Michael F. Furukawa, PhD; and Varun Vaidya, PhD
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Emerging and Encouraging Trends in E-Prescribing Adoption Among Providers and Pharmacies

Meghan H. Gabriel, PhD; Michael F. Furukawa, PhD; and Varun Vaidya, PhD
Using nationally representative transactional e-prescribing data, this study describes the trends of e-prescribing adoption by providers and pharmacies.
In addition to the challenges faced by urban providers, rural providers and pharmacies face unique issues with access, resources, and connection. With this in mind, the RECs have worked with over 50% of eligible providers in rural areas to provide assistance regarding e-prescribing and other requirements of meaningful use. Additionally, the State HIE Program has reached out to rural pharmacies to help facilitate e-prescribing. Our study found no current major differences in provider adoption by rurality. This is in agreement with 2 early studies of physician offices which showed that Health IT adoption and use in rural offices was not lower than in urban offices.24,25

Despite the progress made in the use of e-prescribing, there is also a concern of lack of ability to receive and process e-prescriptions by independent or rural pharmacies for reasons such as availability of broadband Internet and concern over transaction fees. Studies have suggested that incentive programs or grants to help with infrastructure would help to overcome that issue.26 It is important to note that our study reports no difference in ability of pharmacies in rural and urban counties which are actively e-prescribing. This indicates the potential success of incentives, grants, and technical assistance provided to such pharmacies.

With the increase of health IT use among providers and pharmacies, concerns have been raised regarding patient privacy and increased third-party access to health information. It is of note that in the period of this study, those issues do not appear to impede rapid growth in utilization and adoption. However, questions regarding the cost and health benefits of health information technologies such as e-prescribing and EHR use continue to be voiced. This analysis suggests that increasing experience with various HIE technologies such as e-prescribing results in their rapid growth. This is a trend encouraging continued exploration of the clinical and economic benefits of HIE.


Data used for this analysis were generated from prescribers and pharmacies connected to the Surescripts Network and e-prescribing transactions that flow through the network. Due to the strength of market share, Surescripts can serve as a proxy for national trends analysis. While Surescripts captures the vast majority of outpatient transactions, it may not include transactions from a number of sources such as inpatient e-prescribing where the prescription goes directly to the hospital pharmacy, e-prescribing that occurs within a closed integrated delivery network (eg, Kaiser Permanente), and transactions that occur solely on competing networks.


E-prescribing is proving its potential to create a gateway to the improved patient care that health IT promises. The majority of pharmacies in the United States are able to accept e-prescriptions and nearly half of providers are e-prescribing via an EHR. These percentages have increased significantly as pharmacy and prescribing practitioner experience have grown. This study shows positive emerging trends in electronic prescribing by demonstrating accelerated growth in adoption of electronic prescribing at both provider and pharmacy level. Continuous efforts and focused investments can be expected to diminish most of the barriers to implementation in the future.

Author Affiliations: From Office of the National Coordinator for Health IT (MHG, MFF), Washington, DC; College of Pharmacy (VV), University of Toledo, Toledo, OH.

Funding Source: This study was funded by the Office of the National Coordinator for Health Information Technology. The data used for this analysis were procured by ONC/HHS. MFF and MHG are federal government employees at ONC/HHS.

Author Disclosures: The authors (MHG, MFF, VV) report no relationship or financial interest with any entity that would pose a  conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (MHG, MFF); acquisition of data (MHG); analysis and interpretation of data (MHG, MFF, VV); drafting of the manuscript (MHG, MFF, VV); critical revision of the manuscript for important intellectual content (MHG, MFF, VV); statistical analysis (MHG, VV); obtaining funding (MHG, MFF); administrative, technical, or logistic support (MHG); and supervision (MFF).

Address correspondence to: Meghan H. Gabriel, PhD, Office of the National Coordinator for Health Information Technology, US  Department of Health and Human Services, 200 Independence Ave, S.W. Washington, DC 20201. E-mail:
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