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If only John Hancock were writing your prescriptions ...

Doctors' handwriting is notoriously bad. Patients joke that med students must take classes in poor penmanship, just to make sure their prescriptions and chart notes are unintelligible. It is not a joke, though, when a real-life patient is involved. The truth is that an illegible prescription may lead to serious and long-term harm, or what the medical professional calls an adverse drug event.

For example, the abbreviation "o.s." refers to the left eye. The abbreviation "a.s." means left ear. Two drops of ear infection medication can do real damage if they are put in the patient's eye, instead. Pharmacists are trained to recognize these errors, and they often phone the physician with questions. As the issue is being sorted out, though, the patient has no medication, and a delay in treatment can also be harmful.

Technology may be an answer. If handwriting is the worst offender in prescription and medication errors, then a point-and-click system should eliminate the confusion. Advances in medical informatics -- the information technology side of medicine -- have made it possible for more and more doctors and hospitals to transmit prescriptions and other medication information to pharmacists electronically.

In a 2010 study, researchers compared handwritten and electronic prescriptions in an outpatient setting. The clinic's doctors, physician assistants and nurse practitioners used one or the other method over a period of time. The results showed a dramatic, if not alarming, difference.

For every 100 handwritten prescriptions, the researchers found 37 errors. For e-prescriptions, there were just 7 mistakes in every 100 prescriptions. Before anyone in the clinic used the e-prescription system, the error rate was an astonishing 88 per 100; some prescriptions had multiple errors. What's interesting is that the analysis did not include legibility issues.

If e-prescribing is such an effective tool, why aren't more clinics and hospitals using it? We'll discuss that in our next post.

Source: New York Times, "Chicken Scratches vs. Electronic Prescriptions," Randall Stross, April 28, 2012

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