When automobiles first started showing up on America’s streets, a lot of people were skeptical. Cars were noisy and unreliable and many people thought they were just a passing fancy.
Within a few decades, though, cars ruled the roads. Those with horse-drawn buggies were left in the dust.
Computers and email have now become standard means of transmitting information. Compared to handwritten notes, email is quicker, convenient and far more legible. Business relies on email and the Web for efficient communication.
But one sector is lagging far behind. Next time you visit your doctor, chances are very good that you will get a slip of paper hand written in Latin code. It is estimated that fewer than six percent of community physicians prescribe electronically.
In a lot of doctors’ offices, a nurse or receptionist will call in a prescription over the phone. The most high-tech method for transmitting prescription information to the pharmacy is likely to be a fax machine.
These old technologies have not yet reached the status of buggy whips, but they should. They contribute to the millions of prescription errors that occur each year.
A prescription that is called in over the telephone makes it way too easy to confuse sound-alike drug names. A drug for attention deficit disorder, Adderall, might be mixed up with Inderal, a beta blocker for heart and high blood pressure problems. There are hundreds of such combinations, such as the antidepressant Celexa and the schizophrenia medicine Zyprexa.
Look-alike names (Lamisil vs. Lamictal) are also a problem for hand written prescriptions whether they are carried in person or sent by fax. In fact, the fax machine is likely to distort a hard-to-read scrawl and make it illegible.
Medical school professors have admonished their students to do away with Latin abbreviations and codes for decades. But many prescriptions still contain inscrutable instructions such as ac (ante cibum) that means “before meals,” hs (hora somni) that stands for “at bedtime” and qid (quater in die) for “four times a day.” This kind of gibberish doesn’t foster good communication with patients and lends itself to medication mistakes.
Electronic prescribing is not perfect, but it does eliminate the problem of poor handwriting and misunderstood abbreviations. E-prescriptions can be transmitted directly from a doctor’s computer or handheld wireless device to the pharmacy, using secure encrypting technology rather than ordinary email.
When this is done, the pharmacy saves on labor because the e-prescription does not have to be collected and transcribed like a fax. What’s more, e-prescribing usually offers doctors advice on the most commonly approved dosages and the types of serious drug interactions that might occur.
If the doctor has access to the patient’s record electronically, she can check for allergies and drug incompatibilities. This can protect the patient from suffering avoidable complications.
As much as physicians like tradition, the prescription pad is rapidly going the way of the buggy whip. Medical students who have grown up with computers and wireless communication should be far more comfortable with e-prescribing than their mentors.
