I went to a meeting of the New York Health Plan Association this week. Lots of talk about EMRs and e-rx. For a little review of e-rx .. read this RAND paper.
What's compelling to me is that e-rx and EMR are such separate processes, and very rarely integrate. For example – if I want to implement e-rx, I need to work with a company that is doing e-rx. But most EMR products will happily print or even fax an rx, but this is NOT e-rx .. and if I use a separate e-rx product, I don't generate a medication list in my EMR.

A key component of e-rx is that the states need to figger out how to facilitate this. In general, they are not. It's ironic that I can call a pharmacy and say who I am (even if I call from a pay phone) and call in a prescription for a patient — even a 5 day supply for a controlled substance — yet e-prescriptions are subject to vague guidelines.