E-prescribing: A focused review and new approach to addressing safety in pharmacies and primary care

Abstract

Summary E-prescribing, the health information technology (HIT) that enables prescribers to electronically transmit prescriptions to community pharmacies has been touted as a solution for improving patient safety and overall quality of care. However, the impact of HIT, such as e-prescribing on medication errors in acute care settings has been widely studied and show that if poorly designed or implemented, HIT can pose a risk to patient safety by introducing a source of medication errors. Unlike acute care settings, safety issues related to e-prescribing in primary care settings (where e-prescriptions are generated and transmitted) and pharmacies (where e-prescriptions are received) have not received as much attention in the literature. This paper provides a focused review of patient safety issues related to using e-prescribing systems in primary care and pharmacies. In addition, the paper proposes using human factors engineering concepts to study e-prescribing safety in pharmacies and primary care settings to identify safety problems and recommendations for improvement.

The effect of pharmacy information management system on safety medication use: A study from private hospitals in İstanbul

“…In hospital information management system, computerized physician order entry is an application in which physicians write prescriptions online (12). Electronic prescribing is the direct computer-to-computer interaction of prescription information from physician offices to pharmacies in the system (7,8,15). In the pharmacist perspective, a PIMS makes the practitioners aware of non-safety medication usage, the prescribed overdose, the potential effect of the prescription of two drugs concurrently (9).…”

228 Comparison of Primary Compliance in Electronic Versus Paper Prescriptions Prescribed From the Emergency Department

“…For example, with both types of computergenerated prescriptions (e-prescription and printed prescriptions), there are benefits of: eliminated legibility concerns, automated alert system by the computer if a potential allergy or drug interaction is triggered, and increased difficulty to forge. 8,26,29 A number of critiques of e-prescriptions have been noted as well. Perhaps the most alarming critique is an increase in the error rate with e-prescriptions.…”

“…Oversight committees argued that HIT improves quality of care, patient safety, and leads to cost reduction, 7 but across the country physicians and healthcare systems balked at being forced to alter their practice with something they believed would be cumbersome and expensive to implement, cumbersome, had a high potential for errors, altered workflow and efficiency, introduced additional work, and negatively altered the patient-physician interaction. [7][8][9][10][11][12] Despite the pushback, EMRs are now widely adopted and we have seen some areas of undeniable improvement: continuity of records, legibility, and ease of research. We have more easily accessible data now than we ever had before because of HIT.…”

“…Odukoya et al pointed out that these errors are also a significant concern because it causes long delays at the pharmacy while the pharmacists are forced to contact the physician to clarify what was meant. 8 Other critiques against e-prescriptions regard the patient's experience with filling the prescription. In March of 2016, New York became the first state to ban all non-electronic prescriptions and to enforce this by penalizing non-complying physicians with fines and imprisonment.…”

Erros Redacionais Em Prescrições Médicas Em Uma Policlínica De Manaus, Amazonas, Brasil

“…Contudo, esse elo de comunicação está sujeito a riscos como ilegibilidade, má interpretação e falsificações (1). Nesse contexto, tem sido uma tendência mundial a adoção de sistemas de prescrição eletrônica.…”