Is e-Prescribing the answer to reducing med errors?

At my last doctor's visit, I asked for a new prescription for hydrochlorothiazide. Expecting my doctor to pull out her prescription pad like she always does, she surprised me with her iPod Touch. After a few questions and some brushes on the screen, the gadget emitted a sound to indicate that the prescription had been sent to my pharmacy. New decade, new technology for the practice? E-prescribing is still relatively new; it has been available in the last few years. Theoretically, electronic prescribing has a huge potential to reduce the number of prescribing errors associated with paper and verbal prescriptions, but after having seen the errors made with computerized order entry (CPOE) in the hospital setting, I remain skeptical. Undoubtedly, this advanced technology will increase accuracy. As a pharmacist, I can see that less time would be spent on deciphering the scrawls or making phone calls to verify the guess. As a patient, I was happy to see that the label finally had the right doctor's name on it. Now supposedly insurance coverage of the medication would be checked against the formulary ahead of time, so less time would be spent on phone calls by the pharmacist to the insurance companies. Hydrochlorothiazide is an easy one. The only catch was that I had a new insurance plan so the pharmacy could not complete the transaction until I went to pick it up. Convenience is definitely an advantage for e-prescribing on a device that could send and receive data wherever there is wi-fi. Thus, my doctor could send a prescription from home or a coffee shop, if need be. By the way, e-prescribing is not available for controlled substances.

According to an article in the Br J Clin Pharmacol 2008, fewer prescribing errors would lead to fewer pharmacists' interventions, thus improving the quality of prescribing. Some organizations project improvements of patient safety with the avoidance of:

• dosing errors, since the program would be able to calculate doses based on weight for children (hopefully it would know what to do with weights that are off the charts for their age);
• drug-drug, drug-allergy, drug-disease interactions (only if there is a complete drug and disease history on the patient's electronic profile); and
  
• duplication of therapy (again, need a complete profile).

Human errors can still occur, though. The prescriber can still make an error in selecting the drug, dose, strength, route, and instructions. The pharmacist can still misinterpret the prescription and dispense the incorrect product. However, with proper use of e-prescribing, both professionals can be more efficient in their roles to offer better care for the patient. Both would have more time to spend with patients.

E-prescribing is definitely convenient and will help reduce prescribing errors, but it can also open up a can of new errors. My advice? Be as informed as possible. Know what you or your child is being prescribed, how much to give, how often, and for how long before leaving the doctor's office. When picking up prescriptions, make sure they are correct before leaving the pharmacy. Take a few minutes to talk to the pharmacist if the prescription is new to learn about side effects to look out for. Finally, keep that medication list handy and double check that all of the health care professionals (including pharmacists) who care for your child have the most updated information about allergies and current medications.