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H H S Department of Health and Human Services
U.S. Department of Health and Human Services
Health Information Technology and Quality

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What are the choices for an e-prescribing system?

There are two primary types of systems available for e-prescribing, either a standalone system, or e-prescribing within an electronic health record (EHR) system.  Each system has advantages and disadvantages in terms of costs, level of effort, selection and implementation process, impact on the office workflow/productivity, and the ability to communicate with other electronic health information systems. Both types of systems require an investment for hardware and connectivity, the extent of the investment depends upon the system selected.

Standalone system:  These are less costly and less complicated to implement, so they can be used relatively quickly. It is important to note that standalone systems store information associated with the prescribing process (for example drug allergies or medication history). There are two primary forms of standalone products, one that is downloaded directly to the office computer system and is free or uses a standard licensing fee.  The other form allows physician offices to connect to an e-prescribing service provider via the Internet with a transaction fee structure of some kind (i.e. based on the number of e-prescriptions sent) or an annual license fee.  Some standalone products are now offering the ability to upload the patient records or other optional services to interface with the practice management system.

E-prescribing in an EHR system:  While an EHR system is a more costly choice, it does provide immediate electronic access to all the patient data within the EHR system, including diagnoses, laboratory results, clinical notes, etc. Additionally, many of these systems provide clinical decision support to send reminders for immunizations or needed tests. Implementation of an EHR system is also more complex than a standalone system because of the greater need to change the office workflow to incorporate all the features of the EHR system.

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