Content area
While electronic prescribing has been shown to reduce medication errors and improve prescribing safety, it is vulnerable to error-prone processes. We review six intersecting areas in which changes to electronic prescribing systems, particularly in the outpatient setting, could transform medication ordering quality and safety. We recommend incorporating medication indications into electronic prescribing, establishing a single shared online medication list, implementing the transmission of electronic cancellation orders to pharmacies (cancelRx) to ensure that drugs are safely and reliably discontinued, implementing standardized structured and codified prescription instructions, reengineering clinical decision support, and redesigning electronic prescribing to facilitate the ordering of nondrug alternatives.
Details
Patient safety;
Errors;
Safety;
Internet;
Hypertension;
Codification;
Primary care;
Drugs;
Computerized physician order entry;
Prescription drugs;
Reengineering;
Pharmacists;
Systematic review;
Drug stores;
Decision support systems;
Communication;
Privacy;
Medical errors;
Decision making;
Information technology;
Discontinued;
Prescribing;
Pharmacies;
Clinical decision making;
Critical incidents;
Computerized decision support systems;
Medical decision making
1 (gschiff@ partners.org) is associate director of the Center for Patient Safety Research and Practice, Brigham and Women's Hospital, and quality and safety director of the Harvard Medical School Center for Primary Care, both in Boston, Massachusetts
2 project manager in the Center for Patient Safety Research and Practice, Brigham and Women's Hospital
3 founder and CEO of Adviva Health, Inc., in Alexandria, Virginia
4 associate professor, Academic Internal Medicine and Geriatrics, at the University of Illinois at Chicago
5 professor in the Department of Communication Studies and director of the Center for Communication and Health at Northwestern University, in Chicago