In a study by Shah, Aslam and Avery (2001) of approximately 38,000 prescriptions by 23 doctors, there were a number of errors including: 715 or 25% no directions; 510 or 18% prescribed item not mentioned (usually on repeat prescription); 321 or 11%, directions incomplete, illegible or written "as directed"; 306 or 11%, more than one month's supply given on separate repeat prescriptions without patients request; 260 or 9%, strength missing where a product existed in various strengths, and no guidance available in the BNF; 8% or 229, the prescribed quantity was not clearly written, missing or too large; and 5% or 132, prescriber's signature missing. Another 100 errors were due to prescribing medicines no longer available, incorrect medicine because handwriting, no date or wrong strength. Given that this is the digital age, it seems that prescriptions can be easily "written" by computer or some form of electronics, and indeed that is the case. Preece, Ashford and Hunt, as early as 1984, wrote a report noting that the computer was an ideal data base for minimizing errors in subscriptions. Presently, of course, there are many handheld digital tools that can be used for this purpose, which handle problems with abbreviations, misspellings, lack of information and the like. In fact, recent studies show that although it is a change in mindset, especially for geriatric patients, e-scribes have a positive response with patients and significantly improve the amount of errors.

While e-prescribing is growing rapidly, it still represents only a very small amount of prescriptions written each year. About 2% of the 1.5 billion eligible for electronic routing in 2007 were actually filed that way, according to SureScripts, which runs the network allowing physicians and pharmacies to exchange electronic prescribing information....

"We have the technology. We have the interoperability. We know how to make this happen. But not enough people are embracing this rapidly enough," said Sen. John Kerry (D-MA) last year. Kerry, along with several other Democrats and Republicans, sponsored a bill that would initially give doctors a Medicare bonus payment if e-prescribing. If they do not adopt the technology by 2011, however, they would have their payments reduced. However, the American Medical Association says now is not the time for any type of mandate on doctors for new technology. "We worry that there's such frustration out there right now with Medicare payments, that adding a mandate would be something that would cause some physicians to just throw in the towel," says Dr. Joseph Heyman, the AMA's chairman-elect (Rovner, 2007).
Due to the amount of deaths that occur due to the errors in prescriptions, and the ease to change over to e-scriptions, the comment by the AMA is disconcerting. How difficult is to decide to purchase a digital system when lives are at stake?

References

Preece, J.F,. Ashford, J.R and Hunt, R.G. Writing all prescriptions by computer (1984). The Journal of the Royal College of General Practitioners. 34: 654-657

Romano, M. (2002) Patient-safety awards abound, but do they represent real progress in the fight against medical errors, or are they just for show? Modern Healthcare

http://www.modernhealthcare.com/

Rovner, J. (2007) Congress Looks to Require Electronic Prescriptions. NPR

http://www.npr.org/templates/story/story.php?storyId=17170228

Shah, N, Aslam, M, and Avery, a.. (2001) Survey of prescription errors in general practice. Pharmaceutical Journal 267: 861-864.

Sullivan, K. (November 5, 2005) New procedures…