Federal regulations in Canada require prescriptions to be written on paper or communicated orally by physicians. Until these regulations are changed, physicians will be limited in their options.

In 2004, approximately 380 million prescriptions were dispensed in Canada. Each prescription requires that allergy, drug-to-drug and any related diagnostic interactions be checked and a legible prescription produced for the pharmacist to dispense. Unfortunately, this is not standard practice today. Prescribing physician often has incomplete medication histories for their patients and must rely on few available references and/or their own judgment for the appropriateness and safety of the prescription.

The prescribing of drugs has advanced little, if any, in the last fifty years. For example, the current handwriting of orders dates to an era when there was just a few hundred pharmaceutical agents rather than the estimated 17,000 drugs now stocked in typical hospital pharmacies. It is unrealistic to expect today's physicians and pharmacists to understand complex interactions without the support of technological tools and knowledge databases that are available at the point of care.

Although electronic prescribing (e-prescribing) will not eliminate all potential sources of error such as those related to understaffing, it has the potential to reduce errors significantly and dramatically improve prescribing and dispensing processes across the continuum of care.

To move this agenda ahead we need to see a number of actions;

Coordinated leadership from multiple bodies to drive, support and monitor the adoption of e-prescribing solutions across Canada.
A coordinated leadership would create awareness of the benefits of e-prescribing, broker relations among key stakeholders, and influence the scope and adoption of solutions. Importantly, a sense of accountability for successful outcomes could be created among many parties.

A strong "made in Canada" value proposition for e-prescribing that motivates prescribers to adopt the solution is required.
Generally, Canadian physicians have yet to be meaningfully and deliberately engaged in the e-prescribing dialogue, and leaders must continue to find ways to obtain their input and translate that into means of influencing adoption.

Access to comprehensive patient information to support decision making is required at the point of care.
Without the availability of a complete profile of a patient's medications, diagnostic results and any related alerts at the point of care, it is likely that the adoption of e-prescribing will be delayed across Canada.

Interaction with technology at the point of care will facilitate adoption and support productivity.
Tools for e-prescribing must be readily available at the point of care in order to facilitate workflow and reduce time required to access and generate information. Mobile devices or those that are located where physicians and patients interact are most likely to win favour among physicians.

E-prescribing solutions must span the continuum of care in order to realize their full potential and improve the health of the population.
E-prescribing solutions, and drug information systems in general, must span the continuum of care to realize their full potential and facilitate the exchange of information at all points where physicians, nurses, pharmacists and other clinicians interact with patients.

The role that regulation and legislation could and/or should play in facilitating e-prescribing in Canada should be explored and defined.
It is expected that, over a period of time, e-prescribing will become a commonly accepted standard of practice in Canada. What remains unknown is the means through which a standard of practice of practice such as e-prescribing becomes defined, accepted and adopted on a large scale basis.