Standards needed to improve safety of e-prescribing
- February, 13 2016 -
The use of e-prescribing offers gains in efficiency of communication between prescriber, pharmacy and pharmacy benefit manager, but problems involving electronically transmitted prescriptions still exist.
The Use of e-prescribing
prescribing (e-prescribing) eliminating handwritten prescriptions as a contributing factor to drug communication errors. The use of e-prescribing systems offers the potential for other safety gains— integrating patient and drug information at the time of prescribing and sharing of vital patient information between pharmacist and prescriber.
So, not only would illegible Handwriting be removed as a problem, But more integrated information would improve the efficiency and quality of drug communication between prescriber, pharmacy, and pharmacy benefit manager—all positive effects that would benefit the patient.
However, many of these anticipated gains have not yet been fully realized. Integration of e-prescribing software And electronic health records has been slow to develop. Also, as with any new technology, new types of errors may be introduced.
Poorly designed e-prescribing software, Allowing office staff to enter orders, and operator error have contributed to errors. While the prescriptions that are generated are legible, some have other problems that contribute to the risk of error.
Further interaction between vendors, national portals that transfer the information And practitioners who use the software for prescribing or dispensing is needed. Until standards for e-prescribing systems with respect to medication error prevention are developed and implemented, pharmacists should always communicate with prescribers when problems occur.
Practitioners should continue to advocate with the e-prescribing networks, Software vendors, other organizations, for the development of standards and implementation of solutions to improve the safety of e-prescribing systems. To support this effort, pharmacists should report actual errors, close calls, or hazardous conditions related to e-prescribing. If e-prescription is appropriately developed and used, holds great promise for preventing medication errors.
For safety and quality, an ideal system needs suitable information resources, interoperability with other systems and clinical decision support. The goal of clinical decision support is 'to provide clinicians or patients with clinical knowledge and patient-related information, intelligently filtered and presented at appropriate times, to enhance patient care.
The ideal system should record clinical data such as diagnoses, medicines and allergies in a standard coded format. This helps to facilitate one system being able to 'talk to' another system and easily exchange patient data, for example with hospital systems or personal electronic health records when they become available.
Information about recommended therapeutic options for the current diagnosis should be offered. The system ought to ensure that medicine selection processes are safe. In addition to drug interaction alerts, the system should provide warnings if a drug is contraindicated, the dosage regimen is potentially harmful, or if the drug is the subject of new safety advice from the Therapeutic Goods Administration. Warnings need to be prioritized by clinical importance otherwise they may be ignored. Users should be able to see the reason for the alert.
Decision support and therapeutic information offered by the prescribing system Must be underpinned by high quality, up-to-date evidence and guidelines. Independent, evidence-based drug information and clinical practice guidelines should be accessible from within the software. High quality patient resources, such as printable information leaflets and a suitably formatted current medicines list, are also important. The ideal system should have sophisticated reporting capabilities to enable clinicians to monitor clinical care and audit individual or practice performance. The system needs to be intuitive and easy to use in clinical practice.