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ABSTRACT E-prescribing, or the electronic generation of a prescription and its routing to a pharmacy, is generally believed to improve health care quality and reduce costs. However, physicians were slow to embrace this technology until 2008, when Congress authorized e-prescribing incentives as part of the Medicare Improvements for Patients and Providers Act. Using e-prescribing data from Surescripts, we determined that as of December 2010, close to 40 percent of active e-prescribers had adopted the technology in response to the federal incentive program. The data also suggest that among providers who were already e-prescribing, the federal incentive program was associated with a 9-11 percent increase in the use of e-prescribing-equivalent to an additional 6.8-8.2 e-prescriptions per provider per month. We believe that financial incentives can drive providers' adoption and use of health information technology such as e-prescribing, and that health information networks can be a powerful tool in tracking incentives' progress.
Numerous studies have found that the use of health information technology (IT) generates clinical and public health benefits and facilitates improvements in the quality and coordination of care.1-3 Two common examples of health IT in use today are e-prescribing, or the electronic generation of a prescription and its routing to a pharmacy, and electronic health record (EHR) systems. However, despite the benefits that apply to a wide range of health care stakeholders, adoption and use of health IT among the nation's health care providers remained low through the mid-2000s.4
Technology infrastructure to enable physicians to e-prescribe was limited before 2001. Thousands of individual pharmacies and millions of providers lacked the ability to communicate directly with each other. The National Association of Chain Drug Stores and the National Community Pharmacists Association created Surescripts in 2001 to enable electronic prescription routing between providers and pharmacies. Early e-prescribing software was offered to providers either as a stand-alone technology or as part of an EHR system.
By 2004 roughly 0.4 percent of office-based providers, or 2,500 providers, had adopted eprescribing. 5 In 2005 the Centers for Medicare and Medicaid Services (CMS) published a final rule establishing standards for providers and pharmacies using e-prescribing.6 A year later CMS funded five pilot projects to test additional proposed Medicare Part D e-prescribing standards. By 2007 the boards of pharmacy in all...