Trusts urged to move faster with e-prescribing

Trusts are being urged to move forward faster with e-prescribing and the use of robotics to automate hospital pharmacies by the leader of the Healthcare Commission’s medicines management review.

Review lead, Julia Sonander, was speaking to E-Health Insider following publication of comparative assessments on medicines management for all 173 acute hospital trusts in England. Eighteen hospital trusts got the highest rating of ‘excellent’ while 12 got the lowest of ‘weak.’ Seventy trusts got a rating of ‘good’ while 73 were ‘fair’.

Referring to the use of e-prescribing systems she said: “We want to move forward with this faster than we have. Progress has been slow on this and on robotics. A lot of people are waiting for Connecting for Health…which is a shame.”

The National Patient Safety Agency’s National Reporting and Learning System data quoted by the Healthcare Commission, which regulates trusts, shows that 41,220, or 9% of all incidents reported from the acute sector in England and Wales, were related to medication in the year ending July 2006.

The NPSA reports that the vast majority of these incidents (95%) caused no or low harm to the patient.

The Healthcare Commission’s review posed several questions to trusts to assess their progress on the use of IT but the 21 published indicators do not include a specific reference to IT. The indicators cover a range of issues, from the percentage of patients who had had a comprehensive medicines review to whether patients had a complete medicines record for their stay in hospital.

Sonander explained that the commission saw technologies such as e-prescribing and pharmacy robotics as enablers rather than indicators in themselves. However, she added: “What we know is that some of the issues raised in the indicators could be addressed by moving forward with e-prescribing.”

For example, she said, e-prescribing could help with getting prescriptions right first time and freeing up pharmacists to do more of the educational and review work now considered to be good practice. Getting doses right, ensuring prescriptions were complete and legible and picking up errors such as drugs prescribed daily instead of weekly were other examples she cited.

Sonander acknowledged that e-prescribing could do more when linked to an electronic patient record, such as adding checks on a patient’s allergies, but she emphasised that there were gains to be made before this became possible.

She added one caution: “The one thing we have got to be careful of that it [e-prescribing] does not introduce errors. Trusts must ensure it comes into being with a reasonable safety case.”

A national report, outlining in full all of the findings from the medicines management review, will be published later in the year.

Keith Kirtland, sales and marketing director at clinical decision support specialists, First DataBank Europe agreed with the Healthcare Commission’s verdict that more needs to be done to discuss side effects and adverse drug reactions with patients. However, he said there was an infinite number of drugs available and the comprehensive knowledge of these cannot be digested or kept up to date by every provider in every care setting.

Kirtland commented: “The real tragedy of these figures is that there are electronic systems with integrated clinical decision support available here and now which are able to help prevent medication errors. With the ever-increasing pressure on clinicians it is essential that the systems that are available to assist in this key area of patient safety are made available to them at the earliest opportunity."

Medicines management software specialists, Ascribe, sent E-Health Insider an analysis of trusts’ ratings which show 72% of trusts rated ‘excellent’ were using its software, along with 34% of those rated ‘good’, 29% rated ‘fair’ and 17% rated ‘weak’. Chairman and chief executive, Stephen Critchlow, said the two users with ‘weak’ ratings had bought the firm’s software recently to improve their medicines management.