Overview: E-prescribing systems enable the electronic transmissions of prescriptions to pharmacies from the provider's office. The promise of e-prescribing in regard to patient safety is reduction in the time gap between point of care and point of service, reduction in medication errors, and improved quality of care. This paper will give a brief overview concentrating on the reduction in medication errors and the challenges that remain with electronic prescriptions. Electronic prescribing or known as e-prescribing is the transmission, using electronic media, of prescriptions or prescription-related information from a prescriber (physician, nurse practitioner, etc.) to a pharmacy (Fincham, 2009). The information may flow to a number of parties …show more content…
Nurses were the professional group who most often reported medication errors and older patients were those most often affected in the medication errors reports analyzed for this study (Friend, 2011). Medication error type’s revealed omitted medicine or dose, wrong dose, strength or frequency and wrong documentation were the most common problems at Site A where the traditional pen and paper methods of prescription were used; and wrong documentation and omission were the most common problems associated with medication errors at Site B where the electronic MMS was introduced (Friend, 2011). Reports of problems such as wrong drug, wrong dose, strength or frequency, quantity, wrong route, wrong drug and omitted dose were less frequent at Site B (Friend, 2011). The reduced incidence of omission errors at Site B supports suggestions that an advantage of the MMS is easy identification of patient requirements at each drug round time slot. Despite the finding of less omission errors at site B where the MMS had been introduced, there was a relatively high frequency in the incident reports of medication errors related to both omission and wrong dose, strength and frequency at both sites (Friend, 2011). This finding supports claims that, despite a reduction in omission errors, dose errors are still prevalent with a computerized system and minimizing this risk may require consideration of alternative or additional strategies to the introduction of MMS (Friend, 2011). These findings suggest that medical practitioners may have experienced difficulties prescribing using the MMS, which may in part be explained by the relative novelty of the MMS at a new hospital site. Similarly, the research claimed a causative link between MMS and medication errors, attributed to electronic systems that were not very useful or easy to use by medical personnel, generating human-machine interface errors and work flow problems that were not consistent with the usual pen and paper drug
During the 1980’s and 90’s there were many studies done that showed that medical errors were occurring in inpatient and outpatient settings at a very high rate. Computer Provider Order Entry (CPOE) systems were designed to reduce or eliminate mistakes made by using hand written orders. The CPOE system allows users to directly enter their orders into the system on computers which are then sent directly to the healthcare providers that will be implementing the orders. Previously orders were placed by writing on order sheets on patient charts. This was sometimes done by the doctor or by a nurse acting on behalf of the doctor. Order sheets were then signed by the doctor and then the information was input into the patient’s record. This left room for error due to misreading bad handwriting, confusing medications with similar names, etc.
Springfield General Hospital (SGH) is committed to high quality healthcare for patients, and providing tools to support physicians, nurses and pharmacists. SGH leadership approved the computerized physician order entry (CPOE) system as a solution to reduce prescription errors, and the results of the CPOE project are disappointing. The data show increased prescribing errors after implementing the CPOE; resulting in increased costs for adverse drug events, rather than the planned cost reduction (Spector, 2013). This change management plan provides the SGH board of directors and executive management team pragmatic steps to increase quality for patients by assessing the root issue of hospital
Woo, A., Ranji, U., & Salganicoff, A. (2008). Reducing medical errors with technology. Retrieved March, 2012, from http://kaiseredu.org
Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication Error-Related Issues In Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread publicity has helped build awareness of e-prescribing’s role in enhancing patient safety. Although it has not been in practice for very long, e-prescribing has already made a positive impact in the field of health care.
Your post was informative and I agree the benefits of e-prescribing are both a decrease in prescriptions errors. While e-prescribing does present current positive features, and is being mandated, there are risk and the potential for negative outcomes related to its use. Fischer and Rose (2017) reports the benefits of e-prescribing as a decrease in medication errors, illegible prescriptions, and tools to prevent drug and allergy reactions. The negative aspects of the use of the electronic system are also outlined. Health care providers have experienced frustration and found the electronic systems cumbersome as well as pharmacist. The system cannot eliminate all contact with providers and may still require interaction between providers and pharmacies
is considered cost efficient compared to the financial loss the hospital could have incurred if a medication error did occur. (Julie Ann Sakowski & and Alana Ketchel, 2013). E-prescribing is the provider’s ability to request patient prescription electronically directly to their choice pharmacy. E-prescribing is meant to enhance patient safety and aid in reducing medication error. E-prescribing and Bar Code technology work together to provide the ‘right” medication to the patient. When the drug’s bar code is scanned, it alerts the pharmacy staff if there is an error in the medication being dispensed. E-prescribing is supposed to help avoid the errors that occur when providers manually prescribe medications and also help to lower cost by offering less expensive medication.
Within the scope of our findings, there were no major conflicting ideas about the use of electronic barcode medication-administration systems. One study even reported that there were no new types of error in the medication administration process after implementing the barcode medication-administration system into their care (Seibert,H.H., et. al, 2014). There were however some differences in the type of barcode scanning systems used in the research, which can cause some conflicting ideas as to which system was better for reducing medication errors or more user
According to Medicare.gov, electronic prescribing, also known as E-Prescribing, is a way for prescribers (health care providers legally allowed to write prescriptions) to send your prescriptions electronically and directly to your pharmacy. Making it more convenient to just leave the doctor’s office and head straight to the pharmacy, with less wait time.
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
I am truly amazed by the positive impact of bar-code medication administration (BCMA). Since we have a fully integrated electronic health record, it is a true closed loop-system, with medication order entry, pharmacy validation of medications, and clinical decision support. Implementing technology such as BCMA is an efficient way to improve positive identification of both the patient and medication prior to administration. It is estimated that the bar-code medication charting can reduce medication errors by 58% (Jones & Treiber, 2010). Even though we have good adoption of BCMA, nurses still make drug administration errors. In many of the cases, errors are caused by nurses, because they do not validate and verify. The integration of technology
Electronic prescribing is not brand new but it is fairly new and constantly evolving technology that is designed to reduce the risk for sentinel events associated with medications in patients. Electronic prescribing is currently not being utilized by every provider. With all of the benefits, we might wonder what would prevent a provider from utilizing this technology. Not all providers are as excited about implementing e-scribe systems as others. A major barrier reported by a large number of primary care physicians is lack of financial support. As with any type of new technology or implementation of a new device, there will be some initial costs for installation, training and then for upkeep. Many small practices simply do not have the funds to foot the bill to purchase, install and then train there staff on the new software.
In a study by Jacalyn Rogers, Sonya Sebastian, William Cotton, Cheryl Pippin and Jenna Merandi they showed that the number of immunization errors were greatly reduced with the addition of age specific alerts into the electronic prescribing system, With the electronic prescribing system they were able to put age restrictions on different immunizations as well as restrictions on different medications to avoid errors in prescribing a medication to a patient that they either might be allergic to or that might interfere with their current medication. After their seven-month research period they found that with this education on how to properly use this system that prescribing errors decreased from 57% to 25%. They concluded
Scott, D. M., Friesner, D. L., Rathke, A. M., & Doherty-Johnsen S. (2014). Medication error reporting in rural critical access hospitals in the North Dakota telepharmacy project. American Journal of Health-System Pharmacy, 71 (1), 58-67. The authors reported on a 17-month study done where remote pharmacists used telepharmacy technology to review medication orders, identify quality-related events and code clinical interventions. The results of the study show that the North Dakota Telepharmacy model is helpful in resolving quality- related events in critical access hospitals in rural areas. Also, during the study the use of telepharmacy services became more widespread, leading researchers to believe that physicians became more comfortable using the new technology to enhance patient safety.
With the digitalization of the healthcare, it has become almost essential to also implement technology when it comes to pharmacy needs. This tool is a great strategy to help keeping patient medication records safe and well managed (Falconer, Nand, Liow, Jackson, & Seddon, 2014). Also, PIS can potentially reduce medical costs and medical errors (Falconer et al. 2014). For instance, the patient has an allergic reaction to a certain medication by having the PIS linked with the EMR such medical errors can be prevented. Another benefit was satisfied pharmacist and technicians as they can eliminate the not legible handwritten notes by the healthcare providers. One of the biggest challenge faced is having enough funds to support such a collaborative IT interface (Falconer et al. 2014). Also, there is a risk to patient’ healthcare