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Letters to the Editor
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Electronic prescribing
Many hurdles to overcome
From Mr N. G. Ford, MRPharmS
I read with great interest the article
by Stephen Goundrey-Smith (PJ,
21 October, p485). I agree with all he wrote and I believe the article
is a good and brave attempt at summing up the current state of electronic
prescribing in the NHS acute sector. Although, I wish we could change the
shorthand to be more explicit (perhaps “electronic medication management”).
I have been working at Burton on integrating and implementing electronic
prescribing, medication management and patient records systems since 1992.
From my experience these systems are complex and therefore take patience
and perseverance to get right. Mr Goundrey-Smith rightly indicates the
negative effect of the national programme for IT on local work in his article.
I worry that the NPfIT has artificial and arbitrary time deadlines.
I hope Mr Goundrey-Smith will forgive me if I suggest an addition to his
conclusions. Ethics is probably the greatest confounding factor when studying
a system that impinges on patient safety as much as electronic prescribing.
We continually get feedback from all disciplines using our systems and
if we detect medication errors, if at all possible, we change the system,
retrain staff or change procedures or drug use to help prevent future recurrence.
In our experience the confounding factors are too numerous to come to any
meaningful conclusion in a quantitive study. Unlike a drug trial where
there is one intervention to evaluate, with a system as complex and rich
as EP there are thousands all happening simultaneously. Perhaps we should
focus attention and resources towards getting the systems right.
Our experience at Burton is that a well implemented system with sound system
management and design has many real benefits but there are many hurdles
still to overcome to realise the true potential of these systems.
Nick Ford
Pharmacy Department
Burton Hospitals NHS Trust |
The
Pharmaceutical Journal