Healthy tech: E-prescribing reduces prescribing errors

A study published this month in the Journal of General Internal Medicine suggests that some of the $1 billion that the Obama administration wants to spend on health IT may be well spent.

Researchers analyzed prescriptions written by 15 doctor's practices that adopted e-prescribing and 15 practices that continued to use paper, eventually comparing 1543 paper prescriptions with 2305 electronic ones. Among those that adopted e-prescribing they found a huge decrease in errors: From 42.5% to 6.6% at years end. Among the paper-based prescriptions the error rate remained statistically constant: 37% at the study outset and 38% at study end. Naturally the endemic problem of illegible doctor scrawl was entirely eliminated with the e-upgrade.

The offices that were studied where community-based facilities, they type that prescribe over 2 billion drugs are prescribed each year in the US. The e-prescribing systems used were stand-alone, meaning they were not necessarily part of a larger electronic health record. Compared to an entirely e-record keeping upgrade, these systems are obviously much cheaper and easier to integrate in medical practice. In addition to warning doctors when a dosage seems out of the ordinary or missing on the form, or when a new drug could potentially interact with another medication that the patient is taking, such systems can remind providers when refills need to be ordered. But some health safeguards are also needed. Pharmaceutical manufacturers, for example, have developed and offered such systems to doctors free of charge. The catch being that clinical options are programmed to preferentially display the manufacturers products, or query the prescriber to consider their drug over a competitors. Many states have implemented laws to ban such marketing, but they aren't universal yet. As with many technologies, a lack of adequate safeguards can cause marketing opportunities to clash with public health.

In the meantime, this study adds to a substantial body of evidence showing that e-prescribing may be just what the doctor ordered for reducing drug errors.

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