The next time your doctor writes you a prescription, she may reach for a mouse instead of a pen.

A coalition of companies including Cisco, Dell, Google, Intel and Microsoft have banded together to let physicians write prescriptions over the Internet. In addition to warning of potential interactions between drugs, e-prescribing systems can guide doctors to prescribe insurers' preferred brands, particularly generics.

On Jan. 16, the coalition, which has dubbed itself, National ePrescribing Patient Safety Initiative, announced that it was providing free e-prescribing over the Web for computers and handheld devices.

The system will be able to transmit prescriptions electronically to over 95 percent of the nations' pharmacies. Licensed physicians can sign up at www.nationalerx.com.

Two of the health insurance companies in the coalition, Aetna and WellPoint, said that they would provide incentives for physicians to write electronic prescriptions. Another coalition member, Sprint Nextel, is offering free pocket PC phones to doctors who sign up early.

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Coalition members plan to invest about $100 million in the initiative over the next five years. Allscripts, which sells e-prescribing and electronic health records software, is leading the coalition.

Only about one in five doctors in the United States currently write prescriptions electronically, with most saying they can't afford e-prescribing systems or that writing prescriptions electronically would slow them down.

A few years ago, a famous $42 million effort to give away e-prescribing technology and software to doctors failed. Doctors took the free stuff, but did not use it for the intended purposes. Since ten, however, health IT evangelists have made large headways to create more positive attitudes toward health IT.

The initiative is offering a free Web-based system that would instantly check prescriptions for interactions with other medications (powered by a database provided by Wolters Kluwer Health) and would also check how much a patient or plan would have to pay for a drug.

Google is providing a custom search engine to help physicians find relevant information for themselves or patients. Patient information will be stored remotely so that it will not be compromised if a doctors' phone or computer is stolen.

Other members of the coalition include Fujitsu Computers of America, Horizon Blue Cross Blue Shield of New Jersey, and SureScripts, an organization formed by the nation's pharmacy to connect them with doctors' offices.

Rick Spurr, the CEO of ZixCorp, a competing e-prescribing vendor, welcomed the initiative but questioned whether physicians would adopt it. His company's experience is that physicians need a lot of training to see how e-prescribing can fit in a workflow.

"We believe that e-prescribing needs to be free to the doctor, but we don't believe that it can be provided free. It's a complex technology requiring high levels of support for adoption."

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ZixCorp also has a stripped down, Web-based version of its software that it would consider offering for free, he said, but did not expect that to be the case.

"Doctors aren't going to stop a conversation with a patient to walk over to a browser," said Spurr. He questioned whether the software would be sufficiently fast, mobile and ready to use.

Besides, he said, insurers had already shown themselves willing to fund e-prescribing systems because of the savings from prescriptions. According to his data, physicians adjust their prescriptions about twice for every five alerts generated by e-prescribing systems used in Massachusetts' eRX Health Collaborative, for which ZixCorp is the major vendor.

Spurr did not know what fractions of the changes were to prescribe cheaper drugs or to avoid drug-drug interactions, but either switch could save insurers money.

"The competitor put it together, but all boats rise with a rising tide," he said.

Leading health care provider organizations acting as regional supporters of the NEPSI rollout of free electronic prescribing include: Advocate Health Partners, Mount Prospect, Ill; Brown & Toland Medical Group, San Francisco, Calif.; Delta Health Alliance/University of Mississippi Medical Center, Stoneville, Miss.; George Washington University Medical Faculty Associates, Washington, D.C.; Healthcare Partners Medical Group, Torrance, Calif.; Holston Medical Group, Kingsport, Tenn.; LSU Health Network, New Orleans, La.; MaineGeneral Health, Augusta, Maine; Novant Health, Winston-Salem, N.C.; Sierra Health Services and Southwest Medical Associates, Las Vegas, Nev.; UMass Memorial Healthcare, Worcester, Mass.; University of South Florida/USF Physicians Group, Tampa, Fla.

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