NPS releases electronic prescribing systems study

The National Prescribing Service (NPS) has outlined a number of recommendations to enhance the quality, safety and usefulness of general practice prescribing software, with these findings released in their 'Evaluation of Prescribing Systems study'.

According to the NPS report, "there is currently no clear guidance available in Australia about the features of electronic prescribing systems that support patient safety and the delivery of quality care in the general practice setting".

The study, carried out between 2006 and 2009 by a twelve-member expert panel, consisted of three parts:

  1. Developing a prioritised list of features of prescribing software systems that would support patient safety and the delivery of high quality care.
  2. Panel members rated and prioritised the features via a modified Delphi process.
  3. Seven commonly used systems — Best Practice, Genie, Medical Director 2 and 3, MedTech32, Practix and Profile — were tested to see if the features had been implemented.

The study highlighted several issues, including the limited access to evidence‑based drug and therapeutic information available on prescribing software systems. While all systems did provide decision support for drug-drug interactions, little to no decision support was found in regards to harmful dosage regimens or for safety issues relating to certain products.

NPS recommend that national standards and guidance be required to promote the implementation of features to support safety and quality, to produce greater consistency between clinical software systems. They are also calling for software features that support clinical decisions and prescribing safety and quality, including drug dosage, drug‑condition contraindications and a suitably formatted medicine list for patients.

When asked what NPS hopes will come from the study, Chief Executive Officer of NPS, Dr Lynn Weekes explained, “We would like to see clinical software systems used by doctors in day-to-day practice meet key quality and safety criteria. Australia has one of the highest rates of computerisation in general practice in the world, yet until now key safety and quality criteria had not been defined. In the absence of national standards, the features identified in this study should be used as guidance for software developers to improve the functionality of their systems.

"Whilst it is positive that most systems include drug interaction and allergy alerts, there are other important safety features that should be included in all clinical software systems, including alerts for contraindicated drugs, drug dosage support (eg. paediatric dosage, dosage in renal impairment, warnings for potentially harmful doses) and timely warnings about newly identified medicine safety issues. These and other types of decision support should be underpinned by high quality, up-to-date information, and be implemented in such a way that they fit with workflow and are easy to use.

"Australia needs national standards for clinical software to help vendors ensure their products support quality and safety in prescribing, and to ensure that there is a minimum level of clinical functionality that clinicians could expect to find in any system. Government, professional bodies and the software industry each have a role to play in developing standards."

Posted in Australian eHealth

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