The Future of E-Prescriptions Essay

Patient centered care and patient safety are the most important roles in nursing. “Serious medication errors are common in hospitals and often occur during order transcription or administration of medication” (Poon et al., 2010. p. 1). One important aspect of nursing is drug administration. It is a multidisciplinary task including doctors, pharmacist and nurses. This paper will show evidence that using electronic medication systems instead of paper based systems to administer medication will reduce medication errors.

However, changing perceptions of prescribers and consumers will be necessary to launch the initiative. The education of providers regarding the therapeutic equivalent and efficacy of generic medications are therapeutic substitutes is very important—prescribers will be the driving force behind adoption of generics over brand-name drugs. The use of e-prescribing provides information regarding cost, formularies and available generics at the fingertips of providers (United States Department of Health and Human Services, 2010).

The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.

Medication Reconciliation is defined by the Joint Commission as the process of checking and rechecking a patient’s current medication list to the patient’s orders. Within a MedRec program, three steps must be followed to ensure patients have the correct medications at admission and discharge: Verification, Clarification, and Reconciliation (Greenwald et al., 2010; Ruggiero et al,. 2015). MedRec should not occur once, but multiple times especially when a patient moves from department to department. The more a patient moves, the more liable they are for a medication error due to poor communication. MedRec is done for the simple reason of catching those medication errors and correcting them before they can do any harm (The Joint Commission, 2006). Medication errors effect nearly 1.5 million people who enter the hospital setting in the USA. At least every patient has one medication discrepancy between admission and discharge, which leads to rehospitalizations due to hospital-setting medication errors (Institute of Medicine as cited by Wilson et al,. 2015). With nurses at the forefront of a patient’s medication regime, pressure is put on them to provide the necessary education and safety to prevent medication related rehospitalizations. Included in the causes for medication errors is miscommunication between departments taking care of the same patient (Allison et al., 2015). Many medication errors are preventable by the implementation of electronic orders. The use of electronic

These systems will also help cut down on medication errors by comparing the patient’s to medications or interventions so that it is given to the correct patient. Also documents the care given so there would be no human error in the case of questioning whether care had been given as long as the caregiver documents in the record. These features of the electronic health record are in place to promote patient safety by reducing errors.

This is a journal study to investigate the perceptions and opinions of the professional community pharmacy staff about the causes of dispensing errors and strategies to prevent these errors. A survey was completed by pharmacists and pharmacy technicians in 49 community pharmacies and the response rate was 90.9% (Lopes, Joaquim, Matos & Pires, 2015). Handwritten prescriptions were the most single cause of medication errors 51.5% and drugs with similar packages 45.6% (Lopes et al., 2015). Checking prescriptions and confirmation of drugs through barcodes was 97% which were the most agreed prevention methods (Lopes et al., 2015). This article would not only be useful to pharmacy personnel but to other health practitioners or students performing research. In addition, a study similar to this could serve as an example (initiative) that may benefit management. Such initiative would be implemented to help improve medication

Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,

Electronic Health Records (EHRs) are an important component in health care reform, but do they really bring efficiency to the practice? The extent to which practices use EHRs vary from the very basic (entering clinical notes and viewing results) to the intermediate (using e-Prescribing to indicate adverse drug prevention and provide suggestions for alternative drugs) to the advanced use (including lab and radiology order entry with testing guidance, capture of electronic charge, and evidence-based guidelines).

Adoption of EHR can derive a great amount of benefits in clinical outcomes such as patient safety and quality of care. Qualtiy of care can be measured with different dimensions such as patient safety, effectiveness, and efficiency. Patient safety is defined as ‘avoiding injuries to patients from the care that is intended to help them’(Menachemi and Collum, 2011, p. 49). Often times, lack of time can contribute to omission of asking patients important questions such as drug allergy information and confirming important patient identifiers such as addresses/phone numbers. Improvement of medication error is a well-noted benefit of EHR as seen in numerous researches. According to a study, researchers found that a CPOE system was contributory in reducing serious medication errors by 55% in the hospital setting (Bates, 1998). Many other studies have reported similar findings in patient safety improvement. When e-prescribing is used, prescriptions can be checked for any drug interactions with

I cannot to begin to express how often prescription drug errors occur when physicians give patients handwritten prescriptions. E-Prescribing eliminates the chances of illegibility and misunderstanding of instructions on handwritten prescriptions.

Gawande’s (2015) article “Overkill,” suggests that physicians overprescribe drugs and tests which are ultimately unnecessary for patients. To eradicate such behavior, I would implement an electronic health record (EHR) with the following functions: Computerized provider order entry (CPOE) with a clinical decision support system (CDSS) to assist physicians/clinicians (stakeholders) in their medical practice or at hospitals. These functions will help to alleviate redundant tests and make suggestions about treatment. According to HealthIT.gov (2014), CDSS caters chiefly to drugs, laboratory testing, radiology procedures, and helpful clinical literature (HealthIT.gov, 2014).

E-Prescribing is the ability to send accurate prescriptions from the point of care to patient’s preferred pharmacy, electronically. E-prescriptions must be generated by prescribers (physicians or health care providers who are legally allowed to generate prescriptions).

Surescripts collects data from the pharmacy which is available to e-prescription. This provides physicians with information on medications patients paid out of pocket by insured and uninsured patients. When physicians collect a comprehensive medication history, this can enhance physicians to use the Surescripts e-prescription feature for medication reconciliation. A comprehensive medication history may improve drugs interaction alerts which decreases the chance of medication errors and the number of duplicated

Each year thousands of patients die of avoidable medication errors. When a patient is admitted to, transferred within, or discharged from a clinical facility, clinicians should review previous medication orders, current orders and future plans for care, and reconcile differences if there are any. If medication reconciliation is not accurate and systematic, medication errors such as omissions, duplications, dosing errors, or drug interactions may occur and cause harm. Computer-assisted medication applications showed promise as an intervention to reduce medication summarization inaccuracies and thus avoidable medication errors. In this study, a computer-assisted medication summarization application, designed to abstract and represent multi-source

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