New Australia-first research has found medication prescribing errors can be reduced by as much as 66 percent with the introduction of commercial electronic prescribing technology in hospitals and, according to an aged care medication management software maker and commentator, similar results could be achieved in aged care.
With e-health one of the topics ‘du jour’ in health and aged care, an Australia-first study conducted by the University of New South Wales has found “an incredible result” in terms of a reduction in medication prescribing errors from electronic prescribing technology in hospitals.
The UNSW study, which reviewed 3,291 patient records, looked at both procedural (incomplete, unclear medication orders) and clinical (e.g. wrong dose, wrong drug) errors, and rated the potential severity of the errors (minor to serious). It found the implementation of commercial e-prescribing systems led to a fall in prescribing errors of between 58 and 66 percent across three wards in two Australian teaching hospitals compared with a further three wards where the technology was not used.
Above: Professor Johanna Westbrook
Study leader, Professor Johanna Westbrook, from UNSW’s Australian Institute of Health Innovation said the 60 per cent reduction was far beyond anything anticipated. Previous attempts to reduce prescribing error rates in hospitals – such as the introduction of a standardised National Inpatient Medication Chart – had resulted in an improvement of only around four per cent.
“The study provides persuasive evidence of the value of commercial e-prescribing systems to significantly and substantially reduce a range of prescribing errors,” Professor Westbrook said. But, she says, Australian hospitals are only now starting to make multi-million dollar investments in e-health technologies.
“Most of this technology was developed in the US with the big medical centres designing their own customised systems. Hospitals in Australia can’t afford to do that, so they’re taking commercial off-the-shelf systems. We set out to see whether these systems are as effective as the home-grown ones,” Professor Westbrook said.
Professor of Pharmacology at UNSW, Ric Day, helped implement a commercial e-prescribing system at Sydney’s St Vincent’s Hospital. He says prescribing errors are among the top hazards faced in a hospital setting.
“From a clinician’s point of view this is an incredible result given the prevalence and the intractability of the problem. It’s even more significant given that we expect to see greater reductions once user support is added to the systems,” he said.
Above: Chris Gray, Managing Director, iCare.
The aged care setting
Commenting on the study, Managing Director of aged care medication management software provider, iCare, Chris Gray, said electronic prescribing from the medication chart in aged care could produce similar benefits to those highlighted in the UNSW research.
“The Department of Health and Ageing is currently reviewing the practice of medication charts in aged care facilities, in preparation for a national residential aged care chart that will allow PBS claiming directly from the chart, doing away with paper scripts and solving the problem of ‘script owing’ in aged care.
“The next step, once this is in place, is for the Government to enable electronic prescribing from the aged care medication chart. This would realise most of the benefits highlighted in the UNSW research. The ultimate outcome will be a lowering of medication risk for the aged care resident and improved health outcomes.”
Mr Gray said electronic prescribing from the medication chart in aged care would lead to improved safety for the aged care resident through reduced transcription errors; while the potential to develop paperless prescription solutions would largely resolve the ‘script owing’ issue within aged care.
“There would be improved clinical decision making via checking for drug interactions; the ability to generate an electronic medications chart to initiate pharmacy dispensing; and efficiency gains through reduced effort for data entry and transcription,” said Mr Gray.
“For PBS claiming off the medication charts, the target start date is July 1. ePrescribing off the medication chart, however, does not have a time frame, so we need to get the conversation going,” Mr Gray said.