Chapter 4: At the Brink of E-Prescribing

Somehow, Dr. Wigginton knew that his computer could smell fear. For the past several months, the old HP desktop had been freezing just when the office staff needed to print out daily schedules and post incoming insurance checks. All of this was coming at a time when Dr. Wigginton was exploring the possibility of computerizing his medical records and prescribing! Yes, the computer understood very well what was happening; it was an “I’m sorry, Dr. Wigginton, I’m afraid I can’t do that” sort of thing.

When the computer crashed for the last time, his son James opened the tower and discovered that spiders had strung their webs all over the motherboard. And the folks in Washington expected Dr. Wigginton to use a full-blown Electronic Health Record system by 2011?

While the computer repair technician administered CPR to the fickle office computer, James researched handheld devices that Dr. Wigginton could use to access wireless internet for e-prescribing. During his short tenure at his father’s practice, James had noticed that visiting pharmaceutical representatives used sleek tablet PCs to access their marketing information. These computers, which looked like electronic clipboards, would be ideal for carrying between exam rooms and sending quick prescriptions. What was best, these computers generally cost less than $1000 each. James decided that purchasing a tablet PC would save money and help his father e-prescribe without sacrificing efficiency or patient care.

The only problem remaining was to establish a wireless internet connection that would allow Dr. Wigginton to go online from anywhere in the office. As a solution, James purchased a cheap wireless internet transmitter and plugged it into the computer system. Unfortunately, this action caused the practice management computer application to freeze on the remaining office workstations. After spending hours on the phone with tech support, James learned that installing a new wireless transmitter required him to reconfigure the network settings for each computer, printer, and fax in the office. This he did, but not without first incurring the glares of staff who were kept from performing their work while the computers were down.

Finally, when James was at a social function talking to a technically-savvy friend, he learned that wireless networks were extremely vulnerable to hackers. In the medical profession, the prospect of electronic data insecurity is anathema. After learning that information could be compromised through the wireless connection, James made a thorough review of the Nationwide Privacy and Security Framework, a document regulating the electronic exchange of sensitive data. He then beefed up the office’s wireless connection security, thus averting a potential disaster.

Dr. Wigginton and his son could not have anticipated at the outset that the road to an electronic practice was fraught with danger. Just two months before, the horse-and-buggy country doctor would have been hard-pressed to explain what a tablet PC or wireless network were. Through diligent research and unexpected challenges, however, Dr. Wigginton had begun to understand the “hows, whys, and wherefores” of e-prescribing. And yet, if asked to rank his electronic skills on a relative scale, Dr. Wigginton would humbly admit that he was a physician lost in space.