The first consideration when thinking about any type of health information technology is to determine if the medical practice is ready to undertake the effort to successfully implement the technology.  The successful implementation of any new technology takes time, money, and dedicated effort from everyone in the medical practice.  While some forms of technology are easily incorporated into the current work flow in a medical office and do not demand change, e-prescribing represents a fundamental shift in how work is done and  presents medical practices the opportunity to re-engineer or re-design work flow in order to effectively use it.

As with any health information technology, e-prescribing requires medical practices to ask a number of important questions before starting the technology selection process.  These include:

• What do prescribers and others think of e-prescribing?  Are prescribers aware of the benefits and potential time savings of electronic prescribing? Who is the best person in the practice to play a leadership role and "champion" e-prescribing?  Does this person have enough time to play the role well?
• Will the practice use a train-the-trainer approach for in-house instruction? Does the practice have the capacity to recruit a second champion for back-up during absences or staff turn-over?
• Are the prescribers and staff open to change and new technology ?  Has the practice implemented other technology in the past, either successfully or not?  Understanding what has and has not worked in the past can provide valuable guidance for implementing e-prescribing.  For example, was there "buy-in" from everyone involved?  How was the project communicated to staff and stakeholders?
• Are other major projects currently underway?  Given the amount of time and focus needed for the successful implementation of e-prescribing, it might be valuable to consider postponing e-prescribing until the other projects are finished.
• Has everyone in the office been involved in the discussion about e-prescribing?  Because of the scope of change involved in e-prescribing, it is key that everyone in the practice understand the challenges involved in successful implementation.  While these challenges occur in every situation, in some practice types they can be magnified (such as small or rural practices).
• Is top level administration prepared to play the role of coach to keep the project on schedule? Will staff be empowered to preserve the organization's cultural integrity during the transition process?

The following resources provide additional information on determining if the practice is ready:

• Organization Change and Management Toolkit - HRSA Health IT Toolkit
• Physician Office Services Survey - MassPro
• Health Information Technology Readiness Assessment Survey (PDF - 361 KB) - American Medical Association page 13 through 15