Before an e-prescribing option psychiatrists and psychiatric supervisors were limited to:
– Writing & mailing prescriptions,
– Having a local collaborator provide prescriptions,
– Phoning the prescriptions into a pharmacy, which was not previously possible for Schedule II prescriptions such as stimulant medications.
Although the practice of e-prescribing is relatively new, there is emerging evidence that it is already reducing errors, especially those due to illegible handwriting of the prescriber.
Types of Packages
Some e-prescribing packages come with features that provide medication decision-making support which helps to reduce mistakes by:
– Alerting the prescriber if the prescribed dose is outside of the recommended range,
– Indicating potential interactions with other prescribed medications,
– Providing a list of formularies allowed by specific insurance companies,
– Reviewing information about past agents used for the patient,
– And checking on patient allergies.
Although these decision-making support technologies hold promise for helping providers, initial evidence indicates that providers have been slow to embrace such features. Cited reasons have been that the features are cumbersome and that the information gained has not been worth the time or financial investment. Design improvements related to the ease of use, however, have grown to enhance their adoption.
Other advances in these decision-support systems, such as the PDMP database check, are now underway and offer great promise to improve the safety of prescribing Schedule II drugs. Controlled substances are now available to be e-prescribed, as critical changes have been made in the legislature regarding their distribution.
A survey of providers’ attitudes indicates that there are still some concerns regarding the potential requirements of e-prescribing stimulants and benzodiazepines. These concerns include providers not wanting to carry an authentication device such as a random number generator or a universal serial bus drive for a specific computer interface, primarily when they work at more than one facility. However, the ongoing expectations of these providers are that the e-prescribing of controlled substances will reduce medication errors and prevent the diversion of prescriptions for improper or illegal use.