July 23, 2006
IOM Report Calls for E-Prescribing
According to a report issued last Thursday by the Institute of Medicine (IOM), all prescriptions should be written electronically by 2010 in an effort to reduce prescription drug errors. According to the IOM, e-prescribing "is safer because it eliminates problems with handwriting legibility and, when combined with decision-support tools, automatically alerts prescribers to possible interactions, allergies and other problems."
The committee that wrote the report recommended a series of actions for patients, health care organizations, government agencies, and pharmaceutical companies. In addition to recommending that all prescriptions to be written electronically by 2010, other recommendations include steps to increase communication and improve interactions between health care professionals and patients, as well as steps patients should take to protect themselves. The report also recommends the creation of new, consumer-friendly information resources through which patients can obtain objective, easy-to-understand drug information. It also suggests ways to improve the naming, labeling, and packaging of drugs to reduce confusion and prevent errors.
The report finds that more than 1.5 million Americans are injured annually by drug errors in hospitals, nursing homes and physician offices. At least 25% of medication-related injuries can be prevented, according to the report. Technology could help prevent some errors, but hospitals and other providers have little incentive to invest in it, according to J. Lyle Bootman, the University of Arizona's pharmacy dean and chair of the IOM investigation. "We're paid whether those errors occur or not," he said.
Currently, fewer than 20% of prescriptions are electronic (AP/Yahoo! News, 7/20). Three percent of hospitals have electronic health records, the New York Times reports (New York Times, 7/21).Medications' sheer volume and complexity illustrate the difficulty. There are more than 10,000 prescription drugs on the market, and 300,000 over-the-counter products. It's impossible to memorize their different usage and dosage instructions, which may vary according to the patient's age, weight and other risk factors.
Some of the IOM's report recommendations include:
- The government should speed electronic prescribing, including fostering technology improvements so that the myriad computer programs used by doctors, hospitals and drugstores are compatible. E-prescribing does more than counter bad handwriting. The computer programs can be linked to databases that flash an alert if the prescribed dose seems high or if the patient's records show use of another drug that can dangerously interact.
- Patients and their families must be aggressive in questioning doctors, nurses and pharmacists about medications. Get a list of each drug you're prescribed, why and the dose from each doctor and pharmacy you use, and show it at every doctor visit.
- The nation should invest about $100 million annually on research into drug errors and how to prevent them. Among the most-needed studies is the impact of free drug samples, which often lack proper labeling, on medication safety.
- The Food and Drug Administration should improve the quality of drug information leaflets that accompany prescription drugs, but often have incomplete information or are written in consumer-confusing jargon.
- The government should establish national telephone hotlines to help patients unable to understand printed drug information because of illiteracy, language barriers or other problems.
Posted by rsk at July 23, 2006 08:24 AM