Researchers just finished mapping a patient's leukemia tumor genome, finding only eight differences between her tumor cells and normal ones taken from her skin. This breakthrough in medical technology was somehow accomplished while the American Medical Association and U.S. government health agencies are doing a rip and replace of the nation's medication distribution system. Taking the prescription system paperless has been on the national road map since timeshared mainframes were the rage, but up to now, those delivering, managing, regulating, and receiving health care always found wiser uses for the time and money required for a prescription system overhaul.
Now, in the final seconds before an administration sworn to reform health care takes office, e-prescribing is being lofted as a Hail Mary pass by interests with a mix of honorable and questionable intentions. It has not remotely begun to gel, but now it is poor planning made law, and it falls to practitioners, pharmacies, and IT to make it work. Make it work now, or the government will dock already inadequate reimbursement for treatment under Medicare and Medicaid. Company-paid insurance can't be handled any other way.
It probably seems that I'm casting too jaundiced an eye on the issue. Who could oppose the modernization of a paper system whose flaws exact tolls in lives and taxpayer dollars lost to fraud? Trouble is, e-prescribing is loaded with agendas, with conduits for control and work-arounds for potential future regulation and reformation (whatever those may be). It is being executed under the rubric of urgent social necessity, but the health care system has far more pressing issues to deal with. Doctors have less time to see patients, new reasons to refuse to treat patients on government assistance, and new levels of complication that tacitly discourage certain types of prescriptions.
E-prescribing is sold as an essential modernization of a creaky, error-prone, inefficient, and costly paper system that cannot keep pace with the explosive growth of prescriptions. If you didn't know better, you might say they're right. This archaic system has its roots in simpler times when small-town pharmacists knew small-town doctors and their office staff personally. Pharmacists' experience and face-to-face dealings with patients red-flagged erroneous or suspicious prescriptions.