More than 1.5 million people are hurt each year because they receive the wrong prescriptions, often because pharmacists misinterpret the famously illegible scribble on doctors' notes. The federal government announced this week it will try to curb the problem by offering doctors incentives to use electronic prescription systems instead.

"That's a lot of people needlessly hurt and a lot of time to sort out bad handwriting," he said. "E-prescriptions can help us deliver safer, more efficient care to patients."

Utah County's two major health care providers, MountainStar Healthcare and Intermountain Healthcare, say they are working toward implementing electronic systems but are not there yet.

"Right now, most physicians will write a prescription out by hand," said Dr. Scott Williams, chief medical officer for the Mountain Division of the Hospital Corporation of America, MountainStar's parent company. "We've known this has been coming for a while."

With an e-prescription system, orders go from doctor to pharmacist electronically, bypassing errors introduced by a conventional pen-and-pad note. Under the new plan, doctors who start e-prescribing by 2010 will receive a 2 percent premium on their Medicare payments. The bonuses will get progressively smaller for doctors who sign on in subsequent years in a process that, after four years, will start penalizing doctors who have not yet made the switch. Leavitt said the goal is to entice doctors to change in an effort to speed up the transition.

"To get doctors to change the way they prescribe medicine, we need incentives," he said. "E-prescribing is an area that could be improved quickly."

Still, the cost of adopting such a system can be prohibitive, said Kerry Wells, acting administrator of the Centers for Medicare & Medicaid Services. He estimated that the average cost for a physician's office to make the switch is around $3,000. It could run individual offices between $80 and $400 a month to maintain the systems after that, he said.

That includes not just the acquisition cost, but the setup and the training," Wells said.

Dr. James King, president of the American Academy of Family Physicians, said that cost can make it disproportionately harder for smaller practices to switch over. Other obstacles stand in the way as well, he said, including laws that prohibit interstate e-prescribing and pharmacies that are also slow to adopt equipment for receiving electronic orders. But it is an inevitable move and one that will pay off in the long run, he said.

"We know it will increase quality and security," he said. "It increases efficiency, that you'll have more time available to spend with your patients."

Williams said the change is intended to reduce problems mostly originating in clinics, not hospitals, where electronic records are already kept to some degree. About 10 percent of MountainStar's clinics currently do e-prescribing, but the goal is to have all of them on board within six months, he said.

"The biggest source of medical errors is errors in medications," Williams said. "It would really improve our ability to care for patients. It just allows a lot better decision making."

Williams said some physicians may be reluctant to change for fear that using an electronic method will be more time-consuming. But those lost minutes will be easily made up in time not spent on the phone clarifying prescriptions to pharmacies, he said.

"The trick is going to be designing the workflow so it doesn't take more time to do this," he said.

At Intermountain, doctors have already eliminated the handwriting problem by printing out prescriptions, said Dr. Mike Rose, director of the Utah Valley Family Medicine Residency Program. The next step is to fax prescriptions directly to pharmacies -- but it's a process that takes time because it involves cooperation on both sides, he said.

"There are several barriers to successful implementation of electronically transmitting," he said. "Eighty to 90 percent of pharmacies are not set up to receive electronic transmissions."

Rose said Intermountain has been printing prescriptions since 1995. That has already solved most of the problems arising from bad handwriting, he said; the biggest benefit to be had from moving on to electronic systems is better fraud protection. When prescription information goes directly from doctors to pharmacies, there is no chance for opportunistic patients to tamper with the order. He said the timetable for adopting an electronic system is the subject of an ongoing discussion within Intermountain.

• Ace Stryker can be reached at 344-2556 or at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it