Death By Handwriting--escripts to the rescue!

Death By Handwriting

About five years ago I read in one of my pharmacy journals about a new fangled fix for doctor's bad handwriting (technically known as "cacography" and is responsible for thousands of hospital admissions each year, billions of wasted dollars, and millions of wasted phone calls from pharmacists, so hey, no laughing matter), utilizing e-scripts, or electronically transmitted prescription which are generated on a handheld PDA by the prescriber then transmitted to pharmacies. The process, besides eliminating illegible scripts, had the additional benefit of potentially alerting MD's to possible interactions and drugs that would require prior authorizations by insurance companies before being transmitted. That way, the doctor would know that the Biaxin script he/she wrote for on a Friday night would need to be changed to something else that the patient could actually pick up.

(I personally like Montana's solution, fining a doctor $500 per illegible prescription. But who decides what is illegible?)

So, a good thing all around, yes? Well, um, I guess you could say there's a glitch or two.

First, probably because of additional costs, doctor's don't seem to be utilizing the functions, or potential functions, of these e-scripts. Prior authorizations are still common in all types of prescriptions, including e-scripts.

Second, though the scripts are easily read, what the pharmacist is actually reading isn't necessarily what the prescriber meant to write for. Many programs have the medications closely spaced together, allowing for errors of selection. Allegra-D 24 hour can be right below Allegra-D 12-hour. Whoopsies.

An interesting error that I recently ran across was an e-script that had the word "until" next to "7 days." What came out on the potential label was "l7 days." That's a lower case L, not a numerical one. It seems that some programs that doc's use do not allow for automatic line formatting. This particular error was caught by the pharmacist, as he saw that the 17 day supply was unusual. But what if it wasn't? Whoopsies.

So with the new technology we have to be aware that there will be new types of errors occurring, errors that we as yet may not even imagine.


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