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A Prescription for e-Prescribers: Getting the Most Out of Electronic Prescribing

Image displays two computers accepting electronic prescriptions over a network.

90% of pharmacies in the United States are enabled to accept electronic prescriptions (e-prescriptions). 70% of physicians are e-prescribing using an EHR, and each state has an e-prescribing rate of 41% or above.1 If you are using ONC certified health IT, then you are one of the many providers nationwide with EHR technology enabled to prescribe electronically.

This resource highlights some key questions to consider and potential changes you or your practice can make to better manage medication use through the e-prescribing process. Some of these changes can result in decreased pharmacy call backs to the practice, increased patient satisfaction, and improved e-prescribing productivity. Recommendations to create unambiguous prescriptions with standardized information enables effective clinical decision support and enhanced patient safety. While stand-alone e-prescribing systems are available, many of the optimal features and functions described in this guide are only possible through an e-prescribing application integrated with an electronic health record.

Think about your current e-prescribing process as you read through this guide and identify areas you can improve. What issues do you typically face? What is your e-prescribing system capable of doing? Select through each of the steps in the e-prescribing process to learn more about what you should expect from your e-prescribing system, and what you can do to improve the prescriptions you send electronically.

Process for Creating and Managing a Prescription Electronically

This is one example of a workflow for e-prescribing. This outlines, in the broadest sense, the steps that are commonly accepted but does not address specifically who in your practice setting may perform individual steps, or in what order they need to be done.

Image source: “A Clinician’s Guide to Electronic Prescribing 2008”. Image reproduced with permission of eHealth Initiative www.ehidc.org


  1. Identify Patient

    Providers or staff gather patient information, review stored data using sources within the EHR and select the correct patient.

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  2. Review Current Patient Data

    Providers or staff review patient medications using historical information from EHR sources and patient/caregiver interview

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  3. Select Drug

    Providers select the drug to be prescribed from a menu in the EHR.

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  4. Enter Parameters

    Provider enters directions for use and provides all required information to be transmitted to the pharmacy.

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  5. Review Alerts and Advisories

    Provider reviews warnings such as duplicate therapy or drug-drug interactions, and other messages, as well as formulary status and drug benefits.

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  6. Select Pharmacy; Print or Send Rx

    Provider selects pharmacy from patient’s stored preferences and reviews the final prescription before sending.

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  7. Pharmacy Review and Process

    Provider reviews e-prescribing expectations with patients, has staff dedicated to monitoring e-prescription logs, and electronically manages renewal requests.

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1. Gabriel MH, Swain M. E-Prescribing Trends in the United States. ONC Data Brief, no.18. Washington, DC: Office of the National Coordinator for Health Information Technology, July 2014.


The Office of the National Coordinator for Health IT acknowledges the National Council for Prescription Drug Programs Electronic Prescribing Best Practices Task Group and Surescripts Quality Management Program for their contributions to the review and development of this guide.


The information contained in this guide is not intended to serve as legal advice nor should it substitute for legal counsel. The guide is not exhaustive, and readers are encouraged to seek additional detailed technical guidance to supplement the information contained herein. ONC Certification does not guarantee all functionality described in this guide and many functions require individual configuration by the vendor or practice IT staff.

Reference in this web site to any specific resources, tools, products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.