Rx for prescriptions

For better or worse, electronic communication -- email and texting -- has become the preferred communication choice in the United States. One significant casualty of that preference is handwriting. It's rapidly becoming a lost art. Indeed, many schools no longer require the teaching of cursive writing. Despite the changes, there is one area where handwriting still prevails -- in the dispensing of medical prescriptions. And that's a problem.

It's a problem because hand-written prescriptions are often misread by those filling them. The result -- providing the wrong medication or supplying the wrong instructions for a correctly filled prescription -- can sometimes be life-threatening. That's a heavy price to pay for sloppy, illegible writing.

The cost is high. Health care and public officials estimate than at least 1.5 million individuals, and possibly many more, are sickened and some die every year as a direct result of a misread prescription. The estimated annual cost associated with such mistakes is measured in the billions of dollars. There is a preventative available.

A growing number of studies indicates that errors are far less likely to occur if a prescription is filed electronically rather than handwritten on paper.

One survey, for example, indicated an error was made on 37 of every 100 outpatient paper prescriptions filled. By contrast, there were around 7 errors per 100 outpatient prescriptions filed electronically. The number of prescription errors in hospital-based settings in both instances was slightly lower. Most of the errors were not serious, but another survey found that around 7 percent had potential for harm. Given the huge number of prescriptions written annually, even that number is dangerously high.

Fortunately, the move to a safer way of transmitting prescriptions is under way. Unfortunately, the transition is not progressing very quickly. Six years ago, about 20 percent of the nation's prescriptions were produced and sent electronically. Today, that number has grown to about 36 percent, a goodly increase but hardly one that matches the growth rate of, say, smartphones as compared to more traditional cellphones.

The reported increase in electronic prescriptions has had a salutary effect. It has helped reduce the number of what health care professionals call adverse drug events, cases where handwriting is so poor that one drug is improperly substituted for another or incorrect dosages or instructions are printed on a label. Full-scale adoption of electronic prescriptions would significantly reduce those problems. Trouble is, the switch to electronic prescriptions is not cheap, easy or swift.

At the moment, it's still easier and cheaper for most health care providers to write a prescription by hand than to file one electronically. The former requires pen and paper. The latter often requires installation of a full-blown electronic health care record-keeping system that can easily cost thousands of dollars.

Many medical practices, particularly smaller ones, are reluctant to spend that. There is help available through government programs, but payments are tied directly to Medicare and Medicaid reimbursements and spread out over five years. That's a timetable unlikely to spur rapid adoption of new technology.

Switching to electronic prescriptions also requires a change in workplace habits. Traditionally, office workers were not involved in writing a prescription. In the new world of medicine, someone has to electronically enter prescription data. It will take time to integrate that task into the traditional ebb and flow of a medical practice, but it should and will be done.

Another problem is that some pharmacies, most often non-chain businesses or those in rural areas, are unable to receive a prescription electronically. That will change, though, as the use of e-prescriptions rises.

If the nation's health care system is to remain viable, far-ranging changes will have to take place. A major one is the way drugs are prescribed and dispensed. Doing so electronically is more efficient, more cost effective and, most importantly, safer and more consumer friendly.

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