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December 06, 2007

Caveats for e-prescribing

While searching the WSJ online for their coverage of e-prescribing, I ran across a letter posted by a physician in response the an op-ed piece published on Nov. 16, unimaginatively entitled "E-Prescriptions" written jointly by John Kerry and Newt Gingrich.

Steven Hanks, MD, Chief Medical Officer, The Hospital of Central Connecticut, New Britain, Conn. said:

First, in order for electronic prescribing to be truly effective, the information has to flow bidirectionally. Many patients have prescriptions written by a multitude of practitioners, which are then often filled at a number of different pharmacies. For warning alerts regarding interactions or duplications to be effective, the system needs to be able to access all the data.

Second, is our current inability to positively identify patients. Uninsured individuals sometimes "borrow" insurance cards of insureds in order to access needed medications. E-prescribing systems will do little to protect against errors in either of these regards. We should absolutely forge ahead with e-prescribing, but should simultaneously work to assure that all the data repositories talk to one another and that some method of definitively identifying patients, such as a biometric standard, be adopted as well.

These caveats bring up an important point. The ultimate goal in the use of digital technology to improve health care is collaboration, that is, eliminating the data silos that prevent the formation of an integrated system just as much as paper records. The efforts of Kerry and Gingrich to have the gov't provide small incentive for clinicians to start using e-prescribing systems is not enough, especially when it doesn't address the larger issue of collaborative efforts which is the transformative change that is needed.

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