E-prescribing ‘patchy at best’
pharmafile | November 22, 2013 | News story | Medical Communications, Sales and Marketing | DoH, NHS, UCL, e-prescribing
Electronic prescribing in NHS hospitals – seen as one of the cornerstones of public health provision in the future – is currently ‘patchy at best’, according to new research.
Last month the government warned the NHS had been ‘behind the curve’ when it came to technology adoption, but the findings will still be a concern for health secretary Jeremy Hunt, who has pledged to deliver a paperless NHS by 2018.
A survey of 101 hospitals by researchers at University College London (UCL) found that 69% of them had some form of electronic prescribing in place.
However, only one hospital has a system which is used in all clinical areas – including outpatients – with another 12 using electronic prescribing in all adult medical and surgical wards.
This uneven deployment of such systems, and the fact that UCL found about 60 different systems rather than a national, uniform one, creates “huge challenges for both patient safety and staff training”, the researchers say.
They found that a number of hospitals had a system for prescribing inpatient medication plus separate systems for prescribing drugs to take home or for cancer chemotherapy.
And more than half of those hospitals which do prescribe electronically have more than one system – some which are commercially available and others which are ‘home-grown’ ones.
“The level of variation in the use of electronic prescribing between hospital departments, and the diversity of the systems in place, presents a potential threat to patient safety in the form of medication errors,” says Professor Bryony Franklin of the UCL School of Pharmacy.
Since the adoption of electronic prescribing in hospitals is being encouraged by the UK government precisely because it is supposed to increase efficiency and reduce errors – such as the one which killed Gillian Astbury, who died in 2007 of diabetic ketoacidosis while an in-patient – this would appear to be a major problem.
Forty-four people died in the NHS last year as a result of being given the wrong medicine, and the government says the availability of prescription histories could have reduced that number.
The UCL researchers point out that most prescribing by GPs is done using a computer. “In stark contrast to many other developed countries, prescribing for hospital inpatients is generally based on pen and paper,” Franklin says.
In September the government announced another £240 million towards a £500 million package for funding NHS IT – with local health and care systems coming up with the other £500 million themselves, matching the Department of Health’s commitment.
Part of this is for the ‘Safer Hospitals Safer Wards’ fund, which will be used for electronic prescribing, allowing doctors to send computer-generated prescriptions directly to pharmacies using barcodes which are unique to each patient.
Franklin concludes: “Innovative solutions are now needed, making full use of the government funding available, to manage this diversity and facilitate development of safe, comprehensive, hospital-wide systems in a cost-effective way.”
Adam Hill
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