Don't wait to get up to speed on e-prescribing

The Medical Error Rate (MER) is not only high, it is on the rise, due to an increasingly complex health delivery system, managed care demands, and communication failure among physicians, pharmacy, and patients. “There’s growing pressure on everyone involved to reduce medical errors,” according to Philip D. Goldstein, MD, MPH, FAAP, who spoke today at the American Academy of Pediatrics National Conference and Exhibition. “Overall, patients aren’t any safer than they were 5 years ago. And data suggest that children are three times more likely to experience an adverse drug event than adults.” Pediatricians can realize tangible benefits by taking steps now to replace manually written prescriptions with e-prescribing, advised Dr. Goldstein.

E-prescribing is gaining ground as an alternative to hand-written prescriptions. A recent Medco study of 73 Boston-area physicians who used e-prescribing systems showed a 75% medication error reduction and time savings. Further benefits included a 44% improvement in the physician-patient relationship, and a 40% reduction in costs associated with office flow and efficiency.

A variety of software solutions are available to practitioners. Multifunctional applications, such as Epocrates® and Lexi-Comp, include tools such as cross-referenced pharmaceutical databases, dosing calculators, formulary and cost information, and decision support tools. Integrated e-prescribing applications, such as PocketScript® and TouchWorks™, offer integrated databases that are coupled with prescription-generating software, are Web-based, and enable the physician to automatically fax or e-mail the prescription to the pharmacy.

“It’s important to get the buy in of your entire staff, especially those who are averse to technology,” Dr. Goldstein said. “It’s not uncommon for the people involved to suspect a new system represents more work for a limited benefit.”

One problem that Dr. Goldstein has to address from time to time is in pharmacies that are prepared to pick up electronic scripts. However, he contends that his practice is experiencing significantly fewer pharmacy call-backs since implementation.

Dr. Goldstein emphasizes that you don’t need to implement an e-prescibing system all at once - there are important incremental steps pediatricians can take. These include developing an IT plan for your practice, determining what resources you have available, creating long and short-term goals, and involving and educating your staff. Also, Dr. Goldstein says, pediatricians should pursue outside funding, such as what might be provided by payers or hospital/health system affiliates.