Electronic Prescribing

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Electronic Prescribing (ePrescribing)
Introduction

Electronic prescribing (ePrescribing) systems can help improve the safety and efficiency of healthcare by aiding the choice, prescribing, administration and supply of medicines. Electronic prescribing, often abbreviated to e-prescribing or “eRx”, is a form of computer-based physician order entry (CPOE, also referred to as computerized provider order entry and computerized prescription order entry). The safety and effectiveness of ePrescribing systems depends on all staff groups being actively engaged in their development and use.  E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of the major reasons for the push for electronic medical records and electronic health records.

The definition emphasizes that ePrescribing is about communication, certainly more than just prescribing, and encompasses supply and administration as well as other functions such as audit .
ePrescribing involves many types of healthcare professional, and certainly not just prescribers (they maybe doctors, pharmacists or nurses). Nurses and pharmacists, alongside doctors, are the ‘obvious’ key stakeholders for functions such as administration and medicines review, but physiotherapists, dieticians and other healthcare professionals also use inpatient ePrescribing systems when they need to know about a patient’s medicines. Who is involved with implementing ePrescribing?

Because all these healthcare professionals have an interest in using ePrescribing, the implementation of ePrescribing systems has to involve a number of clinical stakeholders as well as the Information Management and Technology (IM&T) professionals who are responsible for the technical infrastructures that support ePrescribing. But before anything it is essential that senior managers and senior clinicians are well informed about and committed to ePrescribing. Without such senior support, ePrescribing projects will be far less able to weather the inevitable setbacks.

Potential Benefits of ePrescribing

Table.1

Purpose
1) Improve patients’ safety and the quality of care. “There are a number of ways e-prescribing can reduce medication errors and resultant adverse drug events” * Illegibility from hand-written prescriptions is eliminated, decreasing the risk of medication errors and decreasing liability risks.

* Oral miscommunications regarding prescriptions can be reduced, as e-prescribing decrease the need for phone calls between prescribers and dispensers. * Warning and alert systems are provided at the point of prescribing. * Access to patient’s medical and medication history.

2) Reducing time spent on phone calls and call-backs to pharmacies. “Physician offices receive over 150 million call-backs from pharmacies with questions, clarifications and renewal requests. Staff nurses spend almost one-third of their time responding to phone calls from pharmacies regarding prescriptions. E-prescribing can significantly reduce the volume of pharmacy call-backs related to handwriting legibility, mistaken manual prescription choices, formulary and pharmacy benefits, positively impacting office workflow efficiency and overall productivity”

3) Eliminates faxes to pharmacies

4) Streamlines refill’s the request and authorization processes. Refill authorization from the pharmacy can be a completely automated process and refills can usually be generated by one click.

5) Increases patient compliance. It is estimated that 20% of paper based prescription orders go unfilled by the patient, E- prescribing systems expedite the filling of prescription at the pharmacy and drug literature can be printed for patients as well.

6) It improves formulary adherence. By checking healthcare formularies at point-of-care, generic substitutions and generic first-line therapy choices are encouraged thus reducing patients cost....
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