Overcoming Ambulatory E-prescribing Adoption Challenges: Governments Shaping Innovation on Behalf of Individual Stakeholders

Ambulatory e-prescribing, at first glance, appears to be a straightforward automation effort that electronically connects an e-prescriber to an electronic network so an e-script can be sent to a pharmacist. The reality is much more complex. The successful implementation of e-prescribing requires stakeholder groups with both a direct and indirect involvement in the technology to cooperate together. By analyzing stakeholders, what becomes evident is that a single individual may actually belong to multiple stakeholder groups. This report brings up adoption issues that have not been emphasized or raised previously. These include the shift in tasks and responsibilities that result from the e-prescribing workflow. Recommendations are targeted to activities that government leaders can fund (e.g., research) or encourage stakeholders to consider. These recommendations show that e-prescribing is more than an automation project. The potential exists to bring diverse stakeholders together to work on collaborative solutions. Yet this stakeholder diversity also stymies the adoption necessary to bring these solutions to fruition.This working paper is a manuscript prepared for the IBM Center for the Business of Government.