Florence dot com: “1. People who prescribe medications should use a system more sophisticated than the pine straw delivery guy’s [pen and paper] to communicate high-stakes drug information. 1,400 commonly prescribed drugs have names that look-alike or sound-alike. People can, and do, die when drug names are confused with one another.
2. Pharmacies should be able to receive prescription data in a format that does not require the tenacity of a middle-school math teacher on summer holiday to decipher.
3. Your electronic medication history–housed with your physicians, pharmacy, and any consumer portal you choose–should move seamlessly into hospital data repositories and be accessible, with your consent, during planned and emergent encounters.”
Barbara Olson does an excellent job of getting to the nuts of bolts of what this piece of an EHR should be about. Prescriptions written by physicians, or other healthcare practitioners, should not be open to intepretation. Orders should not only include basic elements such as drug, dose, route, frequency and indication, but should be easily read as well. While virtually impossible to determine an exact number, it is certain that many drug errors can be attributed to poor hand writing.
The handwriting example shown here is quite famous and resulted in the death of the patient. The physician intended to order Isordil (isosorbide dinitrate) 20 mg orally every 6 hours. The poor handwriting lead the pharmacist to misread the prescription as Plendil (felodipine), a calcium-channel blocker. The pharmacist should have questioned the dose, as the maximum dose of Plendil is 10 mg per day, but did not and the patient suffered a heat attack and died. Better handwriting by the physician, an indication for use as part of the sig or an electronically created version of the prescription could have prevented the death. All simple solutions, but somehow elusive.
