A Mixed Method Study of the Merits of E-Prescribing Drug Alerts in Primary Care

Lapane, Kate L.; Waring, Molly E.; Schneider, Karen; Dubé, Catherine; Quilliam, Brian J.

doi:10.1007/s11606-008-0505-4

Cited by 78 publications

(60 citation statements)

References 13 publications

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“…1 Electronic prescriptions (e-prescriptions) are generated within Computerized Physician Order Entry systems and are electronically transmitted to pharmacies via a secure electronic network between prescribers and pharmacies. 2 e-Prescribing was initially intended to allow for medication orders to be received and processed electronically thereby completely eliminating the use of paper in the processing of prescriptions in pharmacies.…”

Section: Introductionmentioning

confidence: 99%

Retail pharmacy staff perceptions of design strengths and weaknesses of electronic prescribing

Odukoya¹,

Chui²

2012

J Am Med Inform Assoc

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Objective This paper explored pharmacy staff perceptions of the strengths and weaknesses of electronic prescribing (e-prescribing) design in retail pharmacies using the sociotechnical systems framework. This study examined how adoption of e-prescribing technology is affecting clinical practice and patient care. Materials and methods Direct observations and think aloud protocols were used to collect data from seven retail pharmacies. Results Pharmacists and pharmacy technicians reported strengths of e-prescribing design that facilitated pharmacy work which included: legibility, ease of archiving, quick access to prescriptions and consistency in the format of electronic prescriptions (e-prescriptions). Design weaknesses and potential hazards to patient care associated with e-prescribing systems were due to differences between pharmacy and prescriber computer systems which resulted in the selection of wrong patient or drug (name, directions, dose, strength, formulation, package sizes). There were unique strengths and weaknesses in the design of e-prescriptions peculiar to the three pharmacy computer systems examined in this study. Discussion Findings from this study can help inform policy on creating e-prescribing design standards for pharmacy. e-Prescribing system developers can use the results of this study to identify and apply the most usable features of the three main pharmacy computer systems to design systems that support dispensing efficiency and safety. Conclusions This is the first study to highlight design flaws with e-prescribing in retail pharmacies. The sociotechnical systems framework was useful in providing an indepth understanding of the pharmacist and pharmacy technician's interface with e-prescribing technology. This information can be used by policy makers to create e-prescribing standards for pharmacies.

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Section: Introductionmentioning

confidence: 99%

Retail pharmacy staff perceptions of design strengths and weaknesses of electronic prescribing

Odukoya¹,

Chui²

2012

J Am Med Inform Assoc

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“…8 In addition, physician surveys revealed that 40% of prescribers indicate that they override drug-drug interactions most of the time or always. 9 To improve the impact of a BPA, it must be triggered at a proper time, present clear information, and be nondisruptive to the work flow. Although some studies showed that passive BPAs, such as the one we investigated, can effect change, those that require a single-step action are most effective.…”

Section: Discussionmentioning

confidence: 99%

Effect of educational and electronic medical record interventions on food allergy management

Zelig

Harwayne‐Gidansky²,

Gault³

et al. 2016

allergy asthma proc

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“…Paramount among these challenges is the question about the relevance and sensitivity of drug interaction or adverse-effect alerts. 54,55 The existing insensitivity results in many false-positive alerts and subsequently in override rates ranging from 89% to 91%. 25,[56][57][58] Although few studies have been published that assess this phenomenon in children, children tend to be on fewer chronic medications and, because of generally good renal and hepatic function, may be less at risk for severe adverse reactions, 59 thereby magnifying this concern in pediatrics.…”

Section: E-prescribing System Functional Requirementsmentioning

confidence: 99%

Electronic Prescribing in Pediatrics: Toward Safer and More Effective Medication Management

Johnson¹,

Lehmann²

2013

Pediatrics

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This technical report discusses recent advances in electronic prescribing (e-prescribing) systems, including the evidence base supporting their limitations and potential benefits. Specifically, this report acknowledges that there are limited but positive pediatric data supporting the role of e-prescribing in mitigating medication errors, improving communication with dispensing pharmacists, and improving medication adherence. On the basis of these data and on the basis of federal statutes that provide incentives for the use of e-prescribing systems, the American Academy of Pediatrics recommends the adoption of e-prescribing systems with pediatric functionality. This report supports the accompanying policy statement from the American Academy of Pediatrics recommending the adoption of e-prescribing by pediatric health care providers. Pediatrics 2013;131:e1350-e1356The US health care system has the distinction of being the world' s most expensive delivery system while also having among the lowest levels of quality, as judged by many metrics, including infant mortality, life expectancy, and potential years of life lost. 1,2 More specifically, despite US leadership in establishing many standards of care that correlate with improved quality, the US health care system is able to deliver, at best, 60% of the recommended care in most practices. 3,4 Reasons for this inefficiency include the voluminous information resources to consult and the experts' parallel processing and modeling skills (including integrating considerations of the patient' s other illnesses, lifestyle, and genome) required to make an optimal decision. 5 Other challenges include the health care system' s existing methods of payment, which lead to fragmented care. 6 Difficult-to-resolve health disparities also occur when there are suboptimal interactions between a person' s preferences, the regulatory/operational health care system, and internalized biases, stereotypes, or knowledge deficits. All of these challenges to information management affect the delivery of care. 7 For these reasons, health information technology (HIT) has become recognized as a set of tools that complement the provision of care. 8 Electronic prescribing (e-prescribing) is widely recognized as a component of the prescribing process that facilitates handoffs, improves clinical decision-making, and may improve medication adherence. E-prescribing was defined in 2008 by the Centers for Medicare and Medicaid Services as a system providing prescribers with

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A Mixed Method Study of the Merits of E-Prescribing Drug Alerts in Primary Care

Cited by 78 publications

References 13 publications

Retail pharmacy staff perceptions of design strengths and weaknesses of electronic prescribing

Retail pharmacy staff perceptions of design strengths and weaknesses of electronic prescribing

Effect of educational and electronic medical record interventions on food allergy management

Electronic Prescribing in Pediatrics: Toward Safer and More Effective Medication Management

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