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First published February 24, 2006 as JAMIA PrePrint; doi:10.1197/jamia.M2028
Journal of the American Medical Informatics Association 2006;13(3):239-244
© 2006 American Medical Informatics Association

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Submitted on November 30, 2005
Accepted on February 13, 2006

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

John Halamka MD, MS1*, Meg Aranow MPH2, Carl Ascenzo BS3, David W. Bates MD, MSc4, Kate Berry5, Greg Debor BS6, Jessica Fefferman MPH7, John Glaser PhD8, Jerilyn Heinold MPH9, John Stanley BS Pharmacy, MPA10, Diane L. Stone MBA11, Thomas E. Sullivan MD12, Micky Tripathi PhD13, and Bruce Wilkinson MBA14

Affiliation of the authors: 1 CareGroup Healthcare System, Boston, MA; Harvard Medical School, MA-SHARE, Boston, MA; 2 Boston Medical Center, Boston, MA; 3 Blue Cross Blue Shield of Massachusetts, Boston, MA; 4 Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA; 5 SureScripts; 6 Global Health Solutions, Computer Sciences Corporation, Waltham, MA; 7 eHealth Innovation, Blue Cross Blue Shield Massachusetts, Boston, MA; 8 Partners Healthcare, Inc., Boston, MA; 9 Massachusetts Health Data Consortium, Waltham, MA; 10 Tufts Health Plan, Waltham, MA; 11 MA-SHARE MedsInfo-ED, Waltham, MA; 12 President, Massachusetts Medical Society 2003-2004; 13 Mass eHealth Collaborative, Boston, MA; 14 Caremark, Irving, TX

* To whom correspondence should be addressed.

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 which made implementation difficult, and clarified the impact of various types of functionality. We 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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