Digital Medicine

LETTER TO EDITOR
Year
: 2018  |  Volume : 4  |  Issue : 1  |  Page : 46--47

Expanding the reach of electronic prescribing: A call to action


Blake Wassom, Annesha White 
 UNT Health Science Center, Fort Worth, Texas, USA

Correspondence Address:
Blake Wassom
3500 Camp Bowie Blvd, Res Bldg, Office 302E, Fort Worth, Texas 76107
USA




How to cite this article:
Wassom B, White A. Expanding the reach of electronic prescribing: A call to action.Digit Med 2018;4:46-47


How to cite this URL:
Wassom B, White A. Expanding the reach of electronic prescribing: A call to action. Digit Med [serial online] 2018 [cited 2019 Jul 23 ];4:46-47
Available from: http://www.digitmedicine.com/text.asp?2018/4/1/46/232707


Full Text



Dear Editor,

The emergence of computerized physician order entry (CPOE) and electronic prescribing in recent years has contributed to improved patient health outcomes and greater efficiency in the dispensing of prescription medications. However, implementation has been met with challenges, particularly in low- and middle-income countries where slow adoption of evidence-based prescribing patterns and poor infrastructure play a critical role.[1] Commonly cited barriers for developed countries include acquisition and maintenance costs, insufficient training, lack of standardization, and the relevance and timeliness of clinical alerts.[2],[3]

Electronic prescribing offers several benefits compared to traditional handwritten prescriptions including the ability to interface with clinical decision support (CDS) at the point of order entry. In a 2013 review article, Holloway et al. reported that in primary care settings of developing or transitional countries, only 50% of medical interventions were in accordance with standard treatment guidelines.[4] Inappropriate utilization of medications remains a serious problem, one which might be remedied in part by broader implementation of CPOE with CDS and e-prescribing. This technology also reduces the potential for medication errors, a grave concern to health-care systems worldwide. Illegibility and lack of completeness are factors that contribute to medication errors. E-prescribing can mitigate such risks by reducing transcribing errors and facilitating completeness. Other studies have reported cost savings, improved patient safety, and greater coordination of care as a result of e-prescribing.[5]

Each health-care system is unique, and barriers to implementing health information technology should be addressed on a case-by-case basis. However, low- and middle-income countries can look to the successes of developed countries in furthering the implementation of CPOE and e-prescribing. The Medicare Improvements for Patients and Providers Act of 2008 created a 5-year program to incentivize the utilization of electronic prescribing in the United States. Over this period, the percentage of prescribers using e-prescription software in the United States increased from 7% in 2009 to 70% in 2014.[6] Governments of developing countries may consider promoting the adoption of e-prescribing by providing legal and financial incentives to prescribers.[7]

Health information technology has revolutionized modern medicine. The benefits of CPOE and e-prescribing are well-documented in the literature, but much work lies ahead in making it universally accessible. Regardless of the current challenges, health systems should develop a tailored strategy to more fully implement health information technology into the prescribing process.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Akhlaq A, McKinstry B, Muhammad KB, Sheikh A. Barriers and facilitators to health information exchange in low- and middle-income country settings: A systematic review. Health Policy Plan 2016;31:1310-25.
2Hahn A, Lovett A. Electronic prescribing: An examination of cost-effectiveness, clinician adoption and limitations. Univ J Clin Med 2014;2:1-24.
3Moxey A, Robertson J, Newby D, Hains I, Williamson M, Pearson SA, et al. Computerized clinical decision support for prescribing: Provision does not guarantee uptake. J Am Med Inform Assoc 2010;17:25-33.
4Holloway KA, Ivanovska V, Wagner AK, Vialle-Valentin C, Ross-Degnan D. Have we improved use of medicines in developing and transitional countries and do we know how to? Two decades of evidence. Trop Med Int Health 2013;18:656-64.
5Esmaeil Zadeh P, Tremblay MC. A review of the literature and proposed classification on e-prescribing: Functions, assimilation stages, benefits, concerns, and risks. Res Social Adm Pharm 2016;12:1-9.
6Gabriel MH, Swain M. E-Prescribing Trends in the United States. ONC Data Brief, no. 18. Washington, DC: Office of the National Coordinator for Health Information Technology; 2014. Available from: https://www.healthit.gov/sites/default/files/oncdatabriefe-prescribingincreases2014.pdf. [Last accessed on 2018 Jan 29].
7Samadbeik M, Ahmadi M, Sadoughi F, Garavand A. A copmarative review of electronic prescription systems: Lessons learned from developed countries. J Res Pharm Pract 2017;6:3-11.