Show #335 Airing Sunday, 4/2/06
Your doctor scrawls out a prescription. You can't read it, but hopefully the trained pharmacist can. What happens if your pharmacist misreads the prescription and gives you the wrong dosage? Or the wrong medicine? These dangerous mistakes really happen, and you will pay the price. Luckily there's a new option-it's E-Prescribing. And here to describe how E-Scribe can cure prescription pad problems is Dr. Alice Petrulis, medical director of Ohio KePRO.
Question: What are electronic health records? How can I find out if I have one?
Answer: It's your medical history-progress notes, laboratory data, office notes, etc.-electronically on your doctor's computer.
Having this information electronically can allow your doctor to do a multitude of things. For example, the electronic health records can give prompts that can help you receive better care. Say you are diabetic and come to see the doctor for some other reason. An alert may pop up on your electronic health record that you are due for an eye exam, or any other recommended health guideline you might need.
The stored information is very organized. The doctor can look at the information to compare progress, even make graphs the patient can understand to show medical conditions. Hurricane Katrina is an example of how useful E-medical records can be. Doctors with electronic records backed-up elsewhere were able to recreate charts easily. Doctors with paper file files lost everything for their patients.
Don't hesitate to ask your doctor if he/she uses electronic health records and, if he/she does, if various features are in use, like e-prescribing.
Question: What is e-prescribing?
Answer: E-prescribing is the use of electronic health records to send prescriptions to the pharmacy directly from your doctor's computer, as if in an email. The prescription is not faxed and not handwritten (and therefore legible!).
As the prescription is sent, the medication's eligibility with your prescription drug plan/health insurance is checked, and your co-pay is automatically calculated.
There's even a web site available, (epocrates.com) that doctors can go to and either view or download all the health plans formularies. So, if a patient belongs to plan A and that plan doesn't have drug B on it, the doctor can check to see what alternatives there are for that plan. It's free to providers!
Question: Who has e-prescribing?
Answer: If your doctor has been using electronic health records, ask if he/she is set up for e-prescribing.
Major pharmacies, such as Walgreens and CVS, are already set-up for e-prescribing.
Question: What are some of the benefits of e-prescribing?
Answer: The major benefit is to achieve and promote patient safety, reducing errors when filling prescription.
For example, a common mistake due to illegible handwriting is dosage. Q.D. means to take once daily. QID means to take four times per day. A mistake of this magnitude can be dangerous.
Some drugs sound alike/are spelled alike, and this can be a real problem as well. For example, cytoxan, which is a chemotherapy drug, and cytomel, which is a thyroid medication.
The goal is that e-prescribing will help reduce such errors.
It's also for the convenience of the patient, so that they don't lose the prescription.
Question: If our prescriptions are sent electronically, are they safe? Is our privacy protected?
Answer: They are completely safe. The program follows all the privacy guidelines.
Question: Are our health records kept on computers now?
Answer: Unfortunately, not. In Ohio only 15%-20% of medical records are currently electronic on the computer. Unless your doctor is affiliated with a large medical system, they probably do not have E-records.
Question: Can e-prescribing help eliminate dangerous medication combinations?
Answer: Plans are afoot to make this happen, but we're not there yet. Right now, each drug store has its own records, so if a patient goes to several drug stores, medication combinations can still be an issue. However, the eventual goal is to gather records electronically so that all your doctors can see what all your other doctors have prescribed.
Question: How can you learn more about being an advocate for your own health?
Answer: The Agency for Healthcare Research and Quality has a web site where you can find consumer tips for taking medications safely. We'll give that web site and phone number in a moment.
Be an active partner in your medical care. Ask your doctor if he or she uses E-prescribing. For more about how you can be a better consumer, check out the web site or phone number we'll tell you about next. My thanks to Dr. Alice Petrulis.
