London trust sees e-prescribing gains

Chelsea and Westminster Hospital NHS Foundation Trust has realised significant benefits with the completion of its electronic prescribing implementation earlier this year.

Speaking at an ePMA forum held by iSoft in Manchester, India Hardy, the trust’s head of electronic prescribing, said that a large scale analysis of e-prescribing had recognised significant benefits for patient safety as well as trust staff.

The trust dedicated a pharmacist to collecting data for two months before the pilot went live and then for four months after the implementation. It also compared 183 pharmacist interventions that had occurred using paper prescribing and 178 interventions during electronic prescribing.

It found there was an 11% reduction in the severity of errors that were statistically significant and that there were no serious errors when e-prescribing was used, while there was one serious error using hand written prescriptions.

In addition, there were four moderately severe errors when e-prescribing, in comparison to 15 when it was not.

However, the analysis identified that there were more (174 compared to 167) low severity errors made when e-prescribing was used.

Hardy said: “The biggest impact was around moderate and severe errors, which is of course where it is most important.

“However, there is obviously a problem if the numbers go up with e-prescribing. On examination it was clear that these were more system issues than anything else, so this helped us look at some of those issues.”

According to Hardy the study also showed that e-prescribing also reduced the likelihood of being prescribed a medicine when the patient had a known allergy.

She said: “The trust issued mandatory checking of all allergies and decision support into the system, which resulted in a 52% increase in allergy documentation and a 77% decrease in the chance of medications being prescribed when the patient had a known allergy.”

The trust also recognised benefits from measures including providing decision support in dosing and identifying drugs involved in recalls by the MHRA.

Hardy added: “When we look back to our business case, the cost of implementation has been met by the decrease length of stay, litigation costs, time spent by senior staff on incident review, and complaints, and by increasing patient choice and our income from CQUIN (Commissioning for Quality and Innovation).”

Read more about the implementation and its impact in opinion and analysis.