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Physician Michael Finikiotis admits that if there was a competition for illegible handwriting by a doctor when writing a prescription, he would be an awardee.

"I probably have among the worst handwriting in the city," Finikiotis said.

Since June, however, Finikiotis's handwriting, along with that of the other doctors in the UPMC Craig Medical Associates practice, mean little. The Forbes Avenue internal medicine doctors are part of a pilot program the University of Pittsburgh Medical Center initiated to replace scribbling with uniform clarity. The doctors now use electronic PalmPilots to write their prescriptions, which are immediately transmitted to the patient's pharmacy of choice.

"I had a lot of trepidation when we first started the trial. I thought it would be very time-consuming," Finikiotis said. "But that has not been the case. It eliminates phone calls from the pharmacist to clarify prescriptions. We've written, since June, some 8,000 prescriptions by computer."

The University of Pittsburgh Medical Center's efforts to take electronic prescribing -- called ePrescribing -- throughout its organization is getting a substantial $8 million boost from a somewhat unlikely source: its UPMC Health Plan competitor, Highmark Inc.

The region's dominant insurer, Highmark is showing its commitment to electronic prescribing by contributing $26.5 million to the Pittsburgh Foundation to fund an electronic prescription program, with the first phase to include physician funding to defer technology costs.

The foundation, in turn, has created the Highmark eHealth Collaborative to encourage the adoption of health information technology used in patient care.

"This initiative took a lot of planning and discussion over a number of years," said Kenneth D. Melani, Highmark's chief executive. The use of electronic prescription systems and the adoption of electronic health records were identified in 2004 as top priorities by attendees to Highmark's Health Care Cost Summit, Melani added. At the federal level, President Bush in 2004 set a 10-year goal to complete and adopt standards allowing medical information to be stored and shared electronically.

The Pittsburgh Foundation is handling funding for the initiative so that work could be conducted community wide, not be limited to a single payer or customer, and so that the foundation can reach out to other foundations for funding, Melani said.

The collaborative will pay as much as 75 percent of the cost for a physician's office to buy, install and implement an electronic system, as much as $7,000 per doctor. The initiative currently covers 49 of Pennsylvania's 67 counties.

There is little question that electronic prescription transfer saves money, time and possibly lives. Each so-called adverse drug event avoided saves up to $2,000 in unnecessary health are costs, while improving patient care, according to a recent RAND Corp. study. Roughly 8.8 million adverse drug events occur annually. An Institute of Medicine report found that one in 131 ambulatory (not bedridden) deaths were due to adverse drug events.

Not only does the system used by Finikiotis send via e-mail or fax a neat, seemingly typewritten prescription to a pharmacy, the electronic system also allows the physician to cross-check drugs the patient already may be taking or is allergic to, preventing any drug interaction. The system also will tell the doctor if a certain prescription is on the patient's health insurance drug formulary, or list of drugs covered, and it can tell the patient what the prescription will cost.

In the counties where the ePrescribing network will be available, 90 percent of chain pharmacies and 50 percent of all pharmacies are part of SureScripts, one of the largest electronic prescription networks. Among the members are Giant Eagle, Eckerd, Rite Aid, CVS and the Wal-Mart pharmacies.

"We fill tens of thousands of prescriptions daily," said Randy Heiser, Giant Eagle's vice president of pharmacy, in a statement. "The ability to accept these prescriptions electronically will result in greater accuracy, and therefore time savings, for our customers and their physicians."

"Using the system has been an education for me," Finikiotis said. "There have been growing pains; sometimes the computer is slow, but now they would have to fight me to take it back."

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