Study Says E-prescription Systems Would Save At Least 50k Lives a Year

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Study Says E-prescription Systems Would Save At Least 50k Lives a Year

Posted by samzenpus on Monday February 20, 2012 @01:57AM from the take-a-green-pill dept.

First time accepted submitter shirleylopez1177 writes "Approximately 50,000–100,000 people die in America because of preventable adverse events (PAE). These PAEs or medical errors are among the leading causes of death, ranking higher than breast cancer, AIDS and motor vehicle accidents in terms of the number of fatalities caused. As a response to the problem of medication errors, e-prescription systems have emerged. Few studies have looked at how e-prescribing systems compare to traditional systems in their potential to reduce medical errors. However, a study from Australia published two weeks ago in PLoS Medicine examined the impact of e-prescription systems on medication errors in the inpatient setting and demonstrated that these systems are indeed effective."

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10 years ago... by goathumper · 2012-02-20 02:04 · Score: 5, Interesting

I worked on a hospital system 11 years ago that would provide this sort of cross-referencing functionality. It always baffled me why their use wasn't widespread. Back then there were (evidently) no smartphones, etc, so the whole idea of having barcodes on patients' wrists was revolutionary, as was the concept of having computer systems perform the drug-to-pathology matching and medication interactions analyses.
From what I learned working on that project, this sort of system can lower the costs of operation, staffing, and evidently lower risk inside a hospital. Does anyone out there know why they've not seen widespread adoption (besides the "obvious" tin-foil hat doctor-nurse-conspiracy theories)?
1. Re:10 years ago... by Anonymous Coward · 2012-02-20 02:42 · Score: 4, Insightful
  
  inertia.
  No - cost.
  Hospitals have strict budgets and have to penny pinch. The software vendors charge a ludicrous amount for their software - so much that the hospital admins cringe and have a very hard time finding the money. And with these hard times, hospital revenues are in a huge slump - all those unemployed people have lost their health insurance and therefore can't pay their hospital bills - which the hospitals eat much of it. (COBRA is obscenely expensive and if you have a "preexisting" condition, you can't get cheaper insurance or any insurance for that matter; so millions of people go without even when they can afford health insurance.)
  To head off the "software vendors have to worry about lawsuits and that's why they charge so much!"
  No they don't. They have no more product liability costs than any other company and as far as FDA requirements, they've actually reduced some of the regulation.
2. Re:10 years ago... by AngryDeuce · 2012-02-20 02:46 · Score: 4, Interesting
  
  Very much this. Doctors are notorious for being stuck in their ways, especially as concerns administration and computerization. My step-mother actually just quit her administration job at a small practice a few days ago because they were still doing everything on paper; she said she hadn't worked in an office with that minimal level of technology in almost 20 years.
  Especially now as doctor's "margins" are getting thinner due to Medicare cutbacks and such, I'm sure this trend will continue. New tech costs money, and medical tech, even on the administration end, is ridiculously expensive.
3. Re:10 years ago... by demonlapin · 2012-02-20 05:01 · Score: 4, Insightful
  
  I'm a physician whose hospital just tried to push all orders onto electronic order entry - not just medications but diet orders, PT/OT/nursing orders, everything. It got massive pushback. Why?
  
  Most doctors see patients at more than one hospital. Many use an electronic system at their clinic. They have to remember five or six usernames, passwords, and different ways of doing things, any one of which is likely to change at any time due to an upgrade, and some of which they may not use for months (as an example, many surgeons maintain privileges at a wide variety of hospitals to be able to suit patients - but they may not operate at a given one for two or three months at a time). The interface is often clunky. And they're SLOW. Paper is FAST.
  
  Great example from a committee meeting last week: one endocrinologist is part of a group that has taken over management of difficult diabetic inpatients. Most of them have Medicare, or Medicaid, or nothing at all. From his perspective, he's getting paid very little for his work. On paper, he can check blood sugars, write an order, and move on to the next patient in about two minutes. On computer, the same process takes about five minutes. Thirty patients an hour versus twelve... and so he said that if he's forced to do electronic, he will just stop doing the difficult diabetic management. It's no longer worth his time.
  
  And, as others have said, these systems are fantastically expensive, and so while there are some savings to be reaped they are mostly taken by the vendor and the increased IT expenses. And then your vendor decides to EOL your software... what do you do then? Buy their replacement product, because it's a lot cheaper to stay with the same vendor? Buy a new whole-hospital system from another vendor? We're wrestling with that now.
The begin of the article misleads... by Troyusrex · 2012-02-20 02:24 · Score: 5, Informative

by implying that drug errors are causing 50,000 to 100,00 deaths a year when, in fact, drug issues are a very small portion preventable adverse events (PAE). Things like falls and catheter infections are far more common. The article mentions that drug allergies and cross drug reactions are already extremely low and unaffected by implementing e-prescription (probably because the computers in the pharmacy already alert to this). The only thing effected are illegible prescriptions. I think e-prescriptions are a fine idea but this article is misleading as to how much benefit it would have in terms of lives saved.
Re:The solution, according to the summary? by gmack · 2012-02-20 02:29 · Score: 4, Interesting

If the doctor could log in and select the medication and have the pharmacy read the prescription it would, on it's own, prevent a lot of errors that happen from misreading prescriptions. On top of that, if there is something wrong that requires a specialist then the patient is in a fun place where no one doctor knows what all medications are prescribed so a system that did any sort of automated conflict checking could save a lot of lives.
The current system is far from perfect, I once almost lost my job because some pharmacist misread my prescription for Singulair (Asthma med) and gave me an antipsychotic instead and for a week I couldn't be motivated to do anything.