0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Research Letter | Less Is More

Generic Medication Prescription Rates After Health System–Wide Redesign of Default Options Within the Electronic Health Record

Mitesh S. Patel, MD, MBA, MS1,2; Susan C. Day, MD, MPH2; Scott D. Halpern, MD, PhD2; C. William Hanson, MD2; Joseph R. Martinez, BS2; Steven Honeywell Jr, BS2; Kevin G. Volpp, MD, PhD1,2
[+] Author Affiliations
1Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
2Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA Intern Med. 2016;176(6):847-848. doi:10.1001/jamainternmed.2016.1691.
Text Size: A A A
Published online

Extract

This study examines prescription data from the University of Pennsylvania Health System outpatient clinics to compare generic medication prescription rates before and after a redesign of the electronic health record display defaults.

The growing adoption of the electronic health record (EHR) brings new opportunities to improve physician decision making toward higher-value care.1 Default options, or the conditions that are set into place unless an alternative is actively chosen, have been shown to influence decisions in many contexts.2 However, the effectiveness of different ways of implementing defaults has not been systematically examined in health care, and many people may assume that changing defaults is a one size fits all intervention that will always have the same effect.2 In prior work, changing the design of EHR medication display defaults for internal medicine physicians increased generic prescribing rates by 5.4 percentage points.3 In that intervention, the process of searching for a brand-name medication changed from displaying a list of brand-name options followed by their generic equivalents to displaying only generic-equivalent options. To view brand names, a physician had to click on another tab. In November 2014, the University of Pennsylvania Health System implemented a different change in EHR defaults among all specialties across the entire health system. Instead of changing EHR display defaults, an opt-out checkbox labeled “dispense as written” was added to the prescription screen, and if left unchecked the generic-equivalent medication was prescribed. The objective of this study was to evaluate the effect of this intervention on physician prescribing behaviors.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure.
Medications Prescribed as Generic by Drug Class and Month

Data presented are percent of medications prescribed as generic by month from January 2014 to June 2015 for each of the represented drug classes. The vertical gray line represents the intervention in mid-November.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

955 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
Jobs
brightcove.createExperiences();