Electronic Prescriptions in Today’s Health Care World

Most people today have accepted that storing patient information is transitioning from paper to electronic format (i.e., electronic health records (EHR) and electronic prescribing (eRx)). The University of Pittsburgh School of Dental Medicine uses eRx, increasing productivity and accessibility of patient information. Providers are able to share patient information more easily among each other and send eRxs directly to the patient’s pharmacy. The goal is to improve communication among the health care team and quality of health care delivery. This change is a shift towards the future in health care and will be beneficial for the school as well as for the patient.

Moving to a new format means that dental institutions will be confronted with new obstacles. An article came out this week by Westbrook et al. called “The safety of electronic prescribing: manifestations, mechanisms, and rates of system-related errors associated with two commercial systems in hospitals.” The study measures the rate of system-related prescribing errors in relation to the rate of preventable errors. The authors show that new types of errors specifically related to eRx have emerged, but no classification of eRx system-related errors exists. The authors are the first to analyze the rates and mechanisms affiliated with system-related eRx.

The study shows that 42% of prescribing errors are due to system-related errors. Among that percentage, 2.2% are serious mistakes. Despite this high percentage of system-related prescribing errors, the study shows that eRx prevents more prescribing errors than it creates. eRx efficiency is reduced due to system-related errors, but eRx still contributes to patient safety. Surprisingly, the most common system-related error was from the drop-down menu. As an intern in the Informatics Department, we create databases that use drop-down menus in order to reduce errors. For instance, people cannot add wrong information (such as a department name) if that information does not exist.

The next step in the eRx transitioning process will be to train users to properly use the system and to identify and report errors. Recognizing and fixing errors are key components to helping the efficiency and effectiveness of eRx. Overall, the shift to electronic format including eRx is beneficial to the University and patients alike.

Gabriella Basha

MS, Intern at the Center for Dental Informatics