Health Information Technology

Many primary care doctors still do not use electronic antibiotic prescribing for acute infections

Electronic prescribing avoids errors associated with handwritten prescriptions as well as medication interactions, drug allergies, and other problems. Yet many primary care doctors still do not use electronic prescribing systems. A study supported by the Agency for Healthcare Research and Quality (HS14420 and HS14563) found that doctors at nine primary care clinics underused electronic prescribing of antibiotics for acute respiratory infections (ARIs) and urinary tract infections (UTIs).

The researchers noted that barriers to using electronic antibiotic prescribing in primary care must be addressed to leverage the potential that computerized decision-support systems offer in reducing costs, improving quality, and improving patient safety. They retrospectively studied the accuracy of electronic claims diagnoses and electronic antibiotic prescribing for ARIs and UTIs for randomly selected patient visits to nine clinics in the Brigham and Women's Practice-Based Research Network between 2000 and 2003.

The study found that electronic, claims-derived diagnosis codes had good accuracy for identifying ARI and UTI visits in primary care clinics. However, the sensitivity of electronic antibiotic prescribing was poor overall, reflecting the gap between physician note-documented antibiotic prescribing and electronic antibiotic prescribing. Sensitivity increased over time from 22 percent in 2000 to 58 percent in 2003; that is, 58 percent of doctors who prescribed antibiotics used the electronic prescribing system in 2003.

See "Acute infections in primary care: Accuracy of electronic diagnoses and electronic antibiotic prescribing," by Jeffrey A. Linder, M.D., M.P.H., David W. Bates, M.D., M.Sc., Deborah H. Williams, M.H.A., and others, in the January 2006 Journal of the American Medical Informatics Association 13(1), pp. 61-66.

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