Abstract
BACKGROUND AND AIMS: Electronic prescribing (e-prescribing) has emerged as a vital strategy to enhance medication safety, reduce healthcare errors, and streamline clinical workflows. However, its success is largely dependent on user acceptance and satisfaction. This descriptive, exploratory cross-sectional study evaluated physicians' satisfaction with the Social Security Organization's electronic prescription system in two major cities of northeastern Iran-Mashhad and Sabzevar-where the system has been widely implemented in outpatient settings. METHODS: A descriptive cross-sectional study was conducted in 2021 involving 60 physicians selected via convenience sampling. Data were collected through a 36-item researcher-designed questionnaire, which assessed satisfaction with system performance, training quality, technical support, and expected benefits. The questionnaire demonstrated strong reliability (Cronbach's alpha = 0.918) and was validated by a panel of health IT experts and physicians. Data were analyzed using SPSS version 21. Group comparisons and correlation analyses were performed based on experience level, system usage duration, and self-reported computer proficiency. RESULTS: Respondents were predominantly 30-39 years old and reported high levels of digital literacy and motivation to adopt new technologies. Satisfaction was particularly high in areas such as prescription error reduction and the ability to transmit prescriptions to pharmacies electronically. However, a significant proportion of physicians expressed dissatisfaction with system speed, particularly with login and data entry times, and with the lack of adequate training. This led to a notable contradiction where 46.7% of participants acknowledged the system's effectiveness in reducing errors, yet the same proportion indicated they would not recommend it to colleagues. Expectations for improved patient care, workflow integration, and access to medication histories were also emphasized. CONCLUSION: Although the system demonstrated key functional benefits, significant limitations in technical performance, interface usability, and user support infrastructure hindered full acceptance. These findings offer initial, context-specific insights and may serve as a foundation for broader, multi-regional evaluations of e-prescribing systems in Iran. Addressing these shortcomings through targeted training, interface optimization, and performance enhancements is critical to advancing physician satisfaction and long-term system integration.