How Electronic Prescribing Really Works
Doctors often override electronic medication safety alerts and rely instead on their own judgment when prescribing drugs for patients. This suggests that physicians find the alerts more annoying than helpful, according to a new study [gated, but with abstract]. Researchers looked at 3.5 million electronic prescriptions generated by 2,872 doctors. They found:
- About one in 15 prescription orders produced an alert for drug interaction or drug allergy.
- Of those 233,537 alerts, 98.6 percent were for a potential interaction with a drug being taken by a patient.
- Doctors overrode more than 90 percent of the drug interactions and 77 percent of the drug allergy alerts.
Ah, the truth comes out.
Sounds like a lot of money is being spent with no return.
The same problem occurs with PBM alerts generated at the pharmacy during claim submission. In addition to being slower than just writing the script on a prescription pad, this “steals” time from the physicians without improving quality. This adds one more reason why less than 20% of physicians use e-prescribing even occasionally.
Until the vendors figure out how to minimize this “white noise” and increase focus on pertinent alerts we will need other systems to help minimize drug therapy problems. Sophisticated alert identification and notification systems can combine medical and pharmacy claims to provide highly targeted, pertinent and actionable alerts to physicians, pharmacists and other care managers.
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