Impact of office-based e-prescribing on prescribing processes and outcomes

虽然处方药提供了巨大的健康益处，但我们的医疗体系的重大改善， 要取得这些效益，必须先开处方。电子处方（e-prescribing） 是促进更好地开处方的重要手段， 处方过程和更好的医疗结果。了解电子处方系统是否 能够影响预期的变化需要详细研究处方系统，从处方者遇到的 与患者通过电子处方的过程，并对所经历的临床结果， 患者 我们提议的研究将评估电子处方的全方位。我们有一个积极的合作伙伴关系 与已经广泛使用的基于办公室的电子处方系统的制造商， 保险公司和公共计划谁将提供索赔数据。拟议的研究将继续进行 分三个阶段。在第一阶段，我们将使用来自电子处方系统的数据来评估医生 对决策支持干预和警报的响应。在第二阶段，我们将召集专家， 信息技术和经验丰富的调查研究人员开发一项定性研究， 电子处方对处方流程和门诊工作流程的影响，包括一项大规模调查， 详细了解如何将电子处方纳入医疗实践。第三 研究的第一阶段将利用数十年来研究大型医学数据库的经验， 电子处方启动时的处方决策和临床结果。我们会把电子处方 向患者发放这些患者的药房索赔，并将生成一个全面的数据集， 评估电子处方的真正临床影响。 尽管公众对电子处方的兴趣正在增长，包括最近提出的提供电子处方的建议， 电子处方系统的使用方式及其影响的数据 实际上对处方过程和结果的影响仍然相当有限。这项研究的结果将 为临床医生、研究人员、保险公司、政策制定者、患者和所有患有 对改善处方药使用的兴趣。

Although prescription drugs offer tremendous health benefits, significant improvement in our system of prescribing will be required before these benefits can be achieved. Electronic prescribing (e-prescribing) represents an important means of promoting better prescribing, through both increased efficiency in the prescribing process and better outcomes of medical therapy. Understanding whether e-prescribing systems can effect the desired changes requires detailed study of the prescribing system, from the prescriber encounter with the patient through the process of electronic prescribing and on to the clinical outcomes experienced by patients. Our proposed research will evaluate the full spectrum of e-prescribing. We have an active partnership with the makers of an office-based e-prescribing system that is already in widespread use and with multiple insurance companies and public programs who will provide claims data. The proposed research will proceed in three phases. In the first phase, we will use data from the e-prescribing system to evaluate physician responses to decision support interventions and alerts. For the second phase, we will bring together experts on information technology and experienced survey researchers to develop a qualitative study demonstrating the impact of e-prescribing on prescribing processes and outpatient workflow, including a large-scale survey to develop a detailed understanding of how e-prescribing can be integrated into medical practice. The third phase of the research will draw on decades of experience studying large medical databases to evaluate prescribing decisions and clinical outcomes when e-prescribing is initiated. We will link the e-prescriptions issued to patients with the pharmacy claims for those patients and will generate a comprehensive dataset to evaluate the true clinical impact of e-prescribing. Although the public interest in e-prescribing is growing, including recent proposals to provide eprescribing systems to all physicians, the data on how e-prescribing systems are used and what impact they actually have on prescribing processes and outcomes are still quite limited. The findings of this research will provide important lessons for clinicians, researchers, insurers, policy-makers, patients, and all those with an interest in improving the use of prescription drugs.