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E-Prescribing Collaboration in Massachusetts: Early Experiences from Regional Prescribing Projects

Affiliations of the authors: CareGroup Healthcare System and Harvard Medical School and MA-SHARE, Boston, MA (JH); Boston Medical Center, Boston, MA (MA), Blue Cross Blue Shield of Massachusetts, Boston, MA (CA); Division of General Internal Medicine, Brigham & Women's Hospital, Boston, MA (DWB); SureScripts, Alexandria, VA (KB); Global Health Solutions, Computer Sciences Corporation, Waltham, MA (GD); eHealth Innovation, Blue Cross Blue Shield Massachusetts, Boston, MA (JF); Partners Healthcare, Inc., Boston, MA (JG); Massachusetts Health Data Consortium, Waltham, MA (JH); Tufts Health Plan, Waltham, MA (JS); MA-SHARE MedsInfo-ED, Waltham, MA (DLS); Salem Hospital, Danvers, MA (TES); Mass eHealth Collaborative, Boston, MA (MT); Caremark, Irving, TX (BW).

Correspondence and reprints: John Halamka, MD, MS, CareGroup Healthcare System, 1135 Tremont Street, 6th Floor, Boston, MA 02215; e-mail: <jhalamka{at}caregroup.harvard.edu>.

Received for publication: 11/30/05; accepted for publication: 02/13/06.

Massachusetts payers and providers have encouraged clinician usage of e-Prescribing technology to improve patient safety, enhance office practice efficiencies, and reduce medical costs. This report describes three early pilot e-Prescribing projects as case studies. These projects identified the e-Prescribing needs of clinicians, illustrated key issues that made implementation difficult, and clarified the impact of various types of functionality. The authors identified ten key barriers: (1) previous negative technology experiences, (2) initial and long-term cost, (3) lost productivity, (4) competing priorities, (5) change management issues, (6) interoperability limitations, (7) information technology (IT) requirements, (8) standards limitations, (9) waiting for an "all-in-one solution," and (10) confusion about competing product offerings including hospital/Integrated Delivery System (IDN)–sponsored projects. In Massachusetts, regional projects have helped to address these barriers, and e-Prescribing activities are accelerating rapidly within the state.

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