Take one, and stop scribbling on pads of paper

After a shaky start, Massachusetts doctors are beginning to embrace a new way of getting medications to their patients: e-prescribing.

Hospitals and doctors have been turning slowly to technology such as electronic medical records to make healthcare safer and more convenient for patients. And e-prescribing, which allows doctors to send prescriptions electronically over a wireless network to the pharmacy rather than write them on paper, is attracting interest as a less expensive first step.

Two companies that sell the technology are making inroads, despite initial technological glitches and resistance from physicians.

Zix Corp., based in Dallas, has signed contracts with 2,200 doctors, including 650 at Lahey Clinic in Burlington and 700 at Caritas Christi Health Care, to use the company's e-prescribing system, executives said. So far, 473 physicians are active users, writing more than 25,000 electronic prescriptions weekly. Another company, DrFirst Inc., of Maryland, has sold its system to about 750 Massachusetts physicians.

''This is saving me tons of time," said Dr. Abigail Zavod, a Lahey physician who practices in Lexington. Zavod writes most of her prescriptions on a Hewlett-Packard iPAQ, a hand-held computer similar to a BlackBerry. Two of the state's major insurers, Blue Cross and Blue Shield of Massachusetts and Tufts Health Plan, have agreed to transfer their members' medication histories to the Zix database.

This means that when Zavod is on call, covering for other doctors, she can look up medication records for patients she doesn't know but must treat during an emergency. The software alerts doctors if they're about to write a prescription for a drug that could have a dangerous interaction with another of the patient's medications.

Doctors also said that e-prescriptions are more convenient for their patients because they don't have to bring a paper prescription to the pharmacy and wait for the pharmacist to fill it; they simply go pick it up their medication after the doctor sends the order.

E-prescribing companies have struggled. But the idea is picking up steam in Massachusetts, particularly since Blue Cross and Tufts Health Plan, through a nonprofit organization called the Massachusetts eHealth Collaborative, agreed to help pay for the Zix e-prescribing service for doctors for the first year. Companies have tried to sell the service directly to doctors, but Zix is having more success going to insurers to pay for its system, for which it charges about $600 per doctor per year.

The Massachusetts Medical Society, an advocacy organization for the state's physicians, agreed to promote DrFirst's e-prescribing system, in return for the company's providing it to doctors at a steep discount, $150 to $250 a year.

Health insurers are interested in paying for e-prescribing partly because the software checks whether the doctor has chosen the cheapest drug, and if not, suggests a lower-cost alternative, which could save insurers money on soaring drug costs.

''Our device in no way tells doctors how to prescribe, or puts one drug before another; it just provides information," said Bradley Almond, Zix's chief financial officer. "We could never do that because we'd lose the faith of the doctors."

Insurers also say e-prescribing will reduce the number of patients who get the wrong medicine or dose because the pharmacist can't read a doctor's handwriting.

But the systems have drawbacks, and the real test in Massachusetts will come this year, when much of the health plan funding runs out, and doctors decide whether to pay roughly $600 a year themselves to stay with the Zix program.

One drawback is that some doctors who've signed up have discovered they must spend money to update their office technology, because some of the hand-held devices require wireless high-speed Internet access. (Doctors also can send prescriptions from their desktop computers.)

Zix also is struggling to get devices to doctors and convince them to set aside time for training; only about 600 of the 2,200 doctors with contracts are ready to e-prescribe.

''Initially sign-up was a little slower than we expected; now it's going more quickly than we expected," said Dr. Robert Mandel, vice president of provider enrollment and services at Blue Cross. ''We have a significant backlog of people waiting to get deployed. Zix is a small company and when we started it took awhile to hire people" as trainers.

Dr. Alberto Sobrado, a Caritas Christi physician who practices in North Andover, started using the DrFirst system a year ago, and said doctors and nurses in his office now write 80 percent of prescriptions electronically.

''If the Internet is down, it doesn't work. If the electricity goes out, you have to reset it. One of our doctors went someplace and his PDA fell in puddle, and it didn't work," he said.

But he added that the system saves him time. ''Overall, it works very well and I'm glad I'm doing it. But it's going to take awhile before everything is worked out."

Liz Kowalczyk can be reached at kowalczyk@globe.com.