Difference between revisions of "Potential benefits of ePrescribing"

Revision as of 08:20, 29 March 2008

Introduction

The emergence of electronic health records (EHR) has subsequently led to the emergence of other electronic systems to be used in the clinical settings, as anyone might think the primary goal of theses systems is to harmonize the electronic workflow in the clinical settings, but these systems have proven to have an important role in improving the service provided and subsequently the health care in general. One of these systems are ePrescribing systems, which by the use of clinical decision support systems have made a significant change in the way the service is provided which we will discuss later in this paper, but let's first explore the benefits of ePrecribing systems in various types of clinical settings

Why ePrescribing?

In a report of eHealth initiative[1] it was estimated that ePrescribing could save up to $29 bn for the US healthcare systems, $27 bn can be saved directly by sending the prescription electronically to the pharmacy, detecting medication duplication in prescription when different doctors prescribe the same medication and alerting prescribers to a cheaper generic alternatives, The other $2 bn may be saved indirectly through decreasing prescription error and subsequently additional intervention and visits cost.

ePrescribing when combined with clinical decision support systems at point of care can improve the safety of prescription as demonstrated in many studies, one of these studies was a randomize controlled trial (RCT) intended to evaluate the use of handheld systems with a clinical decision support to improve the safety of Non steroidal anti-inflammatory agents prescriptions [2] and concluded that the use of such systems led to a fewer unsafe treatments.

As many of the medical errors are medication errors, ePrescribing can help in reduction of these errors by appropriately offering timely decision support capabilities, proactively detect errors such as drug-drug interactions and drugs that is known to stimulate hypersensitivity reactions for an individual by making use of her/his electronic health record, Also the use of automated prescribing mechanism will lead to preventing the use of unacceptable abbreviations as a potential source of medication errors.

More above avoiding errors is Rational prescribing and the, Rational prescribing is the alignment of prescribing practice and evidences, and a study here shows how an electronic intervention (as one of many other interventions) improved he quality of prescription (of antihypertensive medications).

Another potential benefit of ePrescribing is to do some tasks for physicians, one of the most prominent task is dose calculation specially for children and some drugs where the dose is weight dependent, previously these calculations were done manually and were liable to human error, the study here shows the great benefit of using ePrescribing in ambulatory settings to calculate pediatric dose [3].

Away from benefits behind incorporating clinical decision support; the electronic transfer of the prescription from clinical setting like offices of general practioners directly to community pharmacies, and the idea here finds a great acceptance from the three major stakeholders involved in prescribing process, the physician, the pharmacist and the patient [4]. Our ultimate objective is to produce a prescription with a high quality, however quality of prescription is not correlated to increased expenditure on pharmaceuticals; certainly it will be a cumulative result of safe and rational prescribing.

Refrences

1. Janice Hopkins Tanne, Electronic prescribing could save at least $29bn, electronic communication and health care News.

Report can be accessed www.ehealthinitiative.org 2. ETA S. BERNER, EDD, et al, Improving Ambulatory Prescribing Safety with a Handheld Decision Support System: A Randomized Controlled Trial, J Am Med Inform Assoc. 2006

3. Matvey MD, MS B. Palchuk, Weight-based Pediatric Prescribing in Ambulatory Setting, AMIA SYMPOSIUM2006.

4. T Porteous, C Bond, R Robertson, et al, Electronic transfer of prescription-related information: comparing views of patients, general practitioners, and pharmacists, British Journal of General Practice, March 2003.

Article By:

Mohamed Aly Abd-Elmoneam Clinical Information Systems,BMI-512 Winter 2008