Post date: Jul 12, 2011 3:13:36 PM
The JAMIA paper that concluded e-prescribing had no impact on error rates (see post: e-Rx: Same Error Rates?) has evoked a response statement from Surescripts and the authors. Those of us citing this study are to note that the term e-prescribing as used in the study "does not accurately reflect the way the terms are used today and should be avoided". The e-scripts (from 2008) analyzed in the JAMIA paper were sent by fax or printed out. Note that Surescripts is consistent with the definition but in the 2007 National Progress Report they put it in the fine print (footnote 1). The pioneers of e-prescribing/EMR systems had to efax because there wasn't connectivity (sometimes the EMR - sometimes the pharmacy) - but the escript certainly was computer generated.
While greatly improved now, e-prescribing in the study era forced most pharmacies to dual screen the e-script with the entry form since the pharmacy systems had not incorporated the functionality or pharmacies had not upgraded. So I see the results as being historically valid.
FierceHealthIT blog follows up the joint statement with the post Surescripts' reaction to e-prescribing study doesn't erase the need for improvement. One suggestion of the study was a "forcing function" to make fields required on e-scripts. If my experience yesterday was any indication, one must consider this function carefully. I was getting a medical history taken and many of my medications (or dosage) did not show up on the list. Therefore the clinician chose to omit the drug from the medication history because there was no means of inputting something not on the list.
The Surescripts statement also ignores the fact that e-iatrogenesis errors from computerized inputs can't be ignored.