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Healthcare

Information System Structure in Health Care: Introduction

 

Modern health care systems provide comprehensive tools and resources to improve patient care and wellbeing. The complexity of these networks supports the implementation of information systems using technology-based approaches to expand health care service offerings and the quality of care that is provided in a cost effective manner. From a clinical perspective, an e-prescribing system offers the opportunity for physicians and practitioners to improve communication with pharmacies and health insurance providers to improve prescription drug delivery in a cost effective manner (American Medical Association, 2013). An e-prescribing system also operates to reduce the potential for drug interactions and efficient management of the refill process (American Medical Association, 2013).

Analysis

E-prescribing provides clinicians with an additional tool that will capture relevant data and information in an organized manner so that prescription medication management is an optimal and effective process at all times. These efforts require the utilization of technology-based tools by physicians and practitioners to determine which prescription drugs are appropriate, while also considering past medical history and prescription drug use. By balancing this data with information from health insurance providers, the quality of patient care is likely to improve and remain intact over time. These efforts will also encourage the development of new approaches to prescribing drugs which enables physicians and practitioners to communicate directly and rapidly with pharmacies as needed.

An e-prescribing system is a viable option for many health care organizations because it encourages improved patient care and treatment through a greater understanding of the patient and his or her past medical history and pharmacological intake. One of the key advantages to e-prescribing is the potential for improved patient safety due to the ability to predict possible drug interactions and side effects prior to prescribing a specific formula (Kannry, 2011). When the system is properly utilized, there is a much greater potential to reduce medication errors and to capture dosage information and possible side effects within the patient’s medical record without delay (Kannry, 2011). This option allows other physicians to obtain important prescription drug information prior to making any decisions regarding new scripts (Kannry, 2011).

Many physicians find e-prescribing to be a very useful tool with many positive implications for patient care and treatment outcomes. When this tool is utilized in the appropriate manner, it is likely that it will improve outcomes over time; however, it is also known that software is a concern of many physicians, as some of these programs do not yet provide optimal and standardized results at this time (Jariwala et.al, 2013). Therefore, it is important to recognize that this tool has not been perfected in many organizations, yet it provides much-needed benefits to physicians prescribing drugs for a variety of conditions (Jariwala et.al, 2013). This system must continue to improve through technology-based innovation in order to accommodate the needs of physicians and patients alike (Jariwala et.al, 2013).

Throughout the patient care and treatment process, e-prescribing also promotes the accuracy of scripts, including the appropriate dosages and cross-referencing of possible side effects or drug interactions (Stock et.al, 2009). Accuracy is critical to this process because any type of prescribing error could lead to detrimental if not fatal consequences (Stock et.al, 2009). Therefore, it is important for organizations to consider e-prescribing and its benefits as a viable tool to promote improved access to prescription drug records and histories, particularly for patients who require significant numbers of prescription drugs to combat one or more conditions (Stock et.al, 2009). These efforts will also encourage the development and sustainability of new practice methods within clinics and hospitals so that physicians are on the same page in regards to their prescribing practices (Stock et.al, 2009).

Although e-prescribing is a viable benefit for physicians throughout the health care system, there is not always full confidence in its ability to reduce medication errors and to make processes more efficient and cost effective. Some physicians prefer old-fashioned methods rather than to assume the risks associated with this type of practice, particularly when it has not been proven to be a universal benefit across health care organizations (Grossman, 2010). These findings suggest that in spite of the benefits associated with e-prescribing, some physicians are reluctant to get on board, even if there are financial rewards available to them (Grossman, 2010). Much of this resistance is related to the culture of prescribing drugs, which has been strongly grounded in prescribing on paper and the lack of knowledge or willingness to train with new software and technology-based tools (Grossman, 2010). In one survey, it was determined that “about a quarter of the physicians reporting availability of IT to write prescriptions (23.1%) used the technology only occasionally or not at all” (Grossman, 2010, p. 1). Under these conditions, there remains a disconnect between physicians and e-prescribing tools on the basis of several factors, including the prescribing culture, preference for more traditional methods, and software concerns (Grossman, 2010). Therefore, the implementation of this type of system in a clinical culture where traditional methods are preferred will be more difficult to accomplish, while other organizations with a greater acceptance of technology are likely to listen and accept this practice (Grossman, 2010).

Finally, although there are many advantages to e-prescribing in the context of reducing medication errors, the potential also exists for the reverse scenario, whereby errors are increased as a result of these tools. A study by Nanji et.al (2011) evaluated this problem in the outpatient setting and discovered that ”In this study of computerized prescriptions received by an outpatient pharmacy chain in three states, we found that just over one in 10 computer-generated prescriptions contained errors, and about a third of the errors in prescriptions had the potential for harm. Roughly six in 10 errors related to omitted information, which should be relatively easy to eliminate” (p. 769). Therefore, the e-prescribing tool must be examined carefully before, during, and after implementation to ensure that medication-based errors are minimized as best as possible (Nanji et.al, 2011). These efforts will go a long way in enabling physicians to experience a greater sense of comfort with this tool and the opportunities available to advance medical practice in a positive manner.

Conclusion

The selection and implementation of an e-prescribing system for a clinic or hospital is a highly beneficial tool in promoting efficiency and ease in prescribing medications for patients. With this tool, physicians have greater access to past medical histories, other prescribed medications, possible drug interactions, as well as a direct connection to pharmacies and insurance providers. From this perspective, the e-prescribing tool provides a number of significant benefits and supports the development of new approaches to health care which will improve patient care over time. Although some software e-prescribing systems are problematic and may lead to medication errors, it is important for physicians to consider adopting these systems as a means of greater access to prescribing information that will enable them to make better informed decisions regarding patient care and treatment. Patients are the most important benefactors in using these tools on a regular basis and will be provided with the comfort and security of expert knowledge and decision-making based upon physician expertise and reliability in making prescription-based decisions.

References

American Medical Association (2013). Electronic prescribing systems: what they do. Retrieved               from http://www.ama-assn.org/ama/pub/physician-resources/health-information-technology/health-it-basics/eprescribing.page

Grossman, J.M. (2010). Even when physicians adopt e-prescribing, use of advanced features                    lags. Center for Studying Health System Change, 133, 1-5.

Jariwala, K.S., Holmes, E.R., Banahan, B.F., and McCaffrey, D.J. (2013). Adoption of and                      experience with e-prescribing by primary care physicians. Research in Social and                    Administrative Pharmacy, 9(1), 120-128.

Kannry, J. (2011). Effect of e-prescribing systems on patient safety. Mount Sinai Journal             of Medicine: A Journal of Translational and Personalized Medicine, 78(6), 827-833.

Nanji, K.C., Rothschild, J.M., Salzberg, C., Keohane, C.A., Zigmont, K., Devita, J., Gandhi,                    T.K., Dalal, A.K., Bates, D.W., and Poon E.G. (2011). Errors associated with outpatient          computerized prescribing systems. Journal of the American Medical Informatics               Association, 18(6), 767-773.

Stock, R., Scott, J., and Gurtel, S. (2009). Using an electronic prescribing system to ensure                       accurate medication lists in a large multidisciplinary medical group. Joint Commission              Journal on Quality and Patient Safety, 35(5), 271-279.