Problems I've seen...

1 Sigs: Some say this will eliminate errors. It does decrease some types
of errors, but providers still (rarely) enter the prescription wrong.
Sometimes the mistakes are obvious. Sometimes the mistakes are subtle
and techs don't catch them.

2 Drug selection: The provider will have access to far more drugs than
any pharmacy stocks. For example, think of the variety of topical
steroids that are available, or prenatal vitamins. If a pharmacist is
using a rigorous approach in drug dispensing, he'll be making a lot of
phone calls to the provider, to change the drug to something in stock.

3 Provider transmits rx to XYZ pharmacy, patient shows up at ABC
pharmacy.

4 A mildly troubling case I often encounter: When the pharmacy can
access the providers' information system and prescriptions, patients
will often show up without the prescription, and say the physician was
supposed to transmit it. If you output it yourself, sometimes you wonder
if the patient also has a hardcopy.

5 Poorly trained providers: We make a compounded eyedrop in two
versions: plain and with steroid. Recently received an electronically
generated rx for the plain eyedrops, where the physician indicated in a
footnote, dexamethasone. Upon contacting the clinic, I was told that
they "don't have" an option for the dex version in their database. I
don't know how to access their choices, and it was not a crucial issue
to pursue, but I felt either the provider was not well trained, or the
database has weaknesses.

6 Electronic transmission does little or nothing to address "drug not
covered" issues.