Handwritten prescription slips have always presented risks to patients. The risk of a pharmacist or pharmacy technician misreading a doctor’s handwriting, sometimes known as “chicken scratch” among pharmacists, leads to the risk of a misfilled prescription. This could involve the wrong dosage of a drug, or the wrong medicine entirely, with the consequences ranging from adverse side effects, worsening of a patient’s condition, or even death. New computerized systems for doctors and other medical professionals, however, join the ever-increasing number of electronic solutions to common human errors. These systems can help combat not only pharmacy errors, but also prescription fraud and prescription drug abuse.
Electronic prescriptions, or e-prescriptions (e-Rx), allow a doctor to write a prescription by submitting a request to a pharmacy online, rather than writing out the prescription on a prescription pad. A 2010 study mentioned by the New York Times, which examined handwritten prescriptions from doctors, physician assistants, and nurse practitioners in New York, found a thirty-seven percent error rate for handwritten prescriptions, not including legibility errors. The study found legibility errors in eighty-eight percent of the handwritten prescriptions. These errors can result in a patient receiving the wrong dosage or the wrong medication. They may also result in the pharmacy needing extra time to consult with the prescribing doctor or professional to sort the matter out, which could cause harm to a patient in urgent need of a particular medication.
Congress promoted the use of e-Rx in the 2009 Health Information Technology for Economic and Clinical Health Act (HITECH Act), passed as part of that year’s economic stimulus bill. The HITECH Act establishes certain acceptable uses for electronic medical records, giving regard to issues of patient privacy and the security of patients’ personally identifying information. It specifically names e-Rx as an approved use.
About thirty-six percent of prescriptions written in the U.S. in 2011 used an e-Rx system, an increase from twenty-two percent in 2010. Around 390,000 doctors nationwide were using e-Rx for at least some prescriptions in 2011. Among certain segments of the medical profession, however, e-Rx use may be much more common. InformationWeek reported recently that fifty-eight percent of “office-based physicians” used e-Rx in 2010, a twenty-two percent increase over the previous year. Among solo practice doctors, the number adopting e-Rx increased by fifteen percent between 2010 and 2011. Internists account for the highest percentage of e-Rx adoption among medical specialty groups, followed closely by endocrinologists, cardiologists, and family practitioners.
In addition to its benefits in reducing the number of medication errors, legislators and law enforcement have also come to view e-Rx as a means of fighting prescription drug abuse and fraud. Investigators have seized blank prescription pads from doctors’ offices that they suspect were intended for Medicare or insurance fraud. Cutting down on the use of paper prescription pads would cut off a major source of fraudulent prescriptions and medical bills, and it would also make it far more difficult for prescription drug abusers to obtain drugs.
The Maryland pharmacy error attorneys at Lebowitz & Mzhen can assist you if you have been injured by drugs prescribed or administered incorrectly. Contact us today online or at (800) 654-1949 to see if you may recover damages.
Health Information Technology for Economic and Clinical Health Act (PDF), Public Law 111-5, Title XIII, February 17, 2009
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