Electronic prescribing systems

Komshian, S. Electronic prescribing system helps physicians avoid errors and offer better service. Phys. Comput. 2000, 12-15. 

The doctor writes the dose on the prescription and the pharmacist checks or validates this dose. The validation process may take place with the help of a pharmacy computer system or electronic prescribing system. The usual support offered by pharmacy computer systems is limited if local formulae are used, and the pharmacist may need to consult a range of reference sources when considering the appropriate indications, doses, likely side effects and contraindications. Extra care is required with some patient populations, such as children and the elderly. 

It was reported by the Institute for Safe Medication Practices (ISMP) in 2000 that fewer than 5 percent of physicians were writing prescriptions electronically. In a 2000 white paper entitled, A Call to Action Eliminate Handwritten Prescriptions within 3 Years, ISMP recommended the use of electronic prescribing by clinician order entry to reduce medication errors (ISMP, 2000). CPOE can help to reduce errors in the delivery and transcribing of orders to the pharmacy where the orders are filled. Order management can be used to control inventory and alert pharmacy staff (and even the patient) of the status of a prescription. For example, some national chain pharmacies have the capability of alerting the patient by phone or e-mail if a prescription is ready or if other action needs to be taken before the prescription can be picked up. The system should also be able to report results, such as the number of prescriptions filled, the revenue generated over a specified time, and medication error reports. 

The future appears very bright for electronic prescribing. Certainly, the upfront costs for implementing programs, and the refinement of hardware and software specifics are important issues to resolve. However, the benefits of improved care, streamlined workflow, and more efficient use of clinicians time are important enhancements that have continued to encourage expansion of these technologies. As wider audiences use these applications, continued research is needed to assess the use and refinements necessary to optimally apply these important systems. 

Barriers to electronic prescribing generally circulate around issues of connectivity and ease-of-use issues with physicians, and the cost of implementing this technology in both physician practice and pharmacies. For a seamless system to work, the prescribing physician must have... 

Provide an information system that allows access to patient information for aii staff and allows electronic prescribing... 

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A recent re-examination of the perturbation problem (McWeeny, 1961 Diercksen and McWeeny, 1965), leads to a method of determining, to any prescribed order, the perturbation of an electronic system due to any applied field. This method involves the direct calculation of the first-, second-, third-order corrections to the charge-and-bond-order matrix... 

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