Electronic prescribing

What is electronic prescribing (e-prescribing)?

The use of electronic systems to aid prescribing, administration, and supply of medicines with an audit trail and decision support.

What does EPS stand for?

Electronic Prescription Service.

What are the two main settings for e-prescribing?

Primary care and secondary care.

What is the main function of EPS in primary care?

Sends prescriptions electronically from GP to the patient's nominated pharmacy.

Name three benefits of EPS.

Reduces illegible prescriptions, improves efficiency, prevents form loss.

What issue does EPS help eliminate regarding prescriptions?

Need for re-entry of prescription details at the pharmacy.

What does EPMA stand for?

Electronic Prescribing and Medicines Administration.

What makes hospital e-prescribing systems more complex?

They include drug interaction checkers, clinical decision support, formulary access, and integration with hospital records.

What are examples of integrated hospital systems?

PAS, EMR, EPMA, CDSS.

What were some early UK hospitals to implement e-prescribing systems?

Winchester, Wirral, Burton (1989-1996).

What systems were considered "second generation"?

JAC systems, e.g. GOS, St Mary's, Southampton.

What % of acute NHSE Trusts have EPMA systems?

~35%.

What error types does e-prescribing help reduce?

Prescribing, dispensing, and administration errors.

What % of medication errors in hospitals are prescribing-related?

1.5%-10.3%.

How many IV doses are associated with administration errors?

Around 50%.

What is passive decision support?

Basic input checks and structured fields (e.g. required fields, dropdowns).

What is active decision support?

Real-time alerts for allergies, interactions, and test result integration.

What are order sets and templates used for?

To standardise prescribing and reduce errors.

Name three communication improvements with e-prescribing.

Clearer audit trails, remote prescribing, better interdepartmental messaging.

How does e-prescribing aid formulary management?

Allows integration with approved drug lists and auto-suggested options.

What role does the pharmacist play in e-prescribing?

Verifying medication orders for accuracy and safety.

What tech can aid safe medication administration?

Barcoding.

What must accompany an electronic discharge?

A discharge letter and prescription.

What are common IT-related risks of e-prescribing?

Keystroke and picklist errors, alert fatigue, overreliance on automation.

What are "workarounds" in electronic systems?

User-devised solutions that bypass standard system protocols, often leading to safety risks.

What does "alert fatigue" refer to?

Ignoring important alerts due to excessive or irrelevant system notifications.