PATIENT RECORDS
Has electronic prescribing reached its
Stephen Goundrey-Smith
Will a GMC report raising serious concerns about the accuracy of prescribing in hospitals turn the tide in favour of e-prescribing? National Health Executive asks Stephen Goundrey-Smith, author of the seminal Principles of Electronic Prescribing, where we go from here
P
icture the scene. A doctor is attending a fitness to practise hearing at the General
Medical Council. She stands accused of making a prescribing error which has lost a patient his life. The doctor is now fighting for her career.
Meanwhile, managers at the trust which employs her are facing their own problems. The latest inspection report from the new government’s health service watchdog has led to serious questions about why the trust has not implemented a system which is known to cut the risk of prescribing errors significantly. The managers’ careers are also in jeopardy.
even the most ardent champions of
e-prescribing would have to confess that it is still far from widespread throughout Britain’s NHS hospitals
among doctors at every stage in the career path. Shockingly, the study found that almost nine per cent of medication orders contained errors, more than half of which were deemed “potentially significant”.
The GMC report finds a number of reasons for the level of mistakes and makes some headline recommendations, including the need to introduce consistency in prescribing forms from hospital to hospital.
But the report also states clearly that “electronic prescriptions were 12 per cent less likely to be associated with a prescribing error than handwritten prescriptions.”
If, as this report and others suggest, ditching the handwritten prescription can improve patient safety and save lives can managers, doctors – and regulators –afford to ignore it?
This scenario is not as far- fetched as it might currently seem. A report published recently by the GMC, the regulatory body for doctors, on prescribing in hospitals raises serious questions about how accurately it is done. Although it was based on the most junior doctors (foundation years), the study of prescribing errors found they were all too common
70 nhe
Stephen Goundrey-Smith, a pharmacist by background and author of the respected Principles of Electronic Prescribing (Springer, 2008), which remains the “go-to” book for e-prescribing in the UK, believes the GMC report is significant.
“This is a sign that regulators are getting interested in the whole area,” he says. “Once there is a
professional requirement to use appropriate systems, it will be difficult for trusts to ignore.”
According to the NHS’s Connecting for Health, the earliest adopters of electronic prescribing have had systems in place for over a decade1.
Yet even the most ardent champions of e-prescribing would have to confess that it is still far from widespread throughout Britain’s NHS hospitals.
There are several reasons for this, says Stephen Goundrey- Smith. What he calls the “political angle” is important.
“We’ve spent many years thinking that there was going to be a national system; we now know that it’s not going to happen in quite that way but people’s reluctance was understandable.”
The need for a real change management programme throughout the organisation – and getting buy-in from everyone, not just those who were keen to use the new technology – was seen as a barrier by some.
There has also been some natural caution. “People wanted to be sure that the systems work,” he says.
Nov/Dec 10
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100