Opelka: E-prescribing is safe and private

Critics are spreading misinformation that could prevent patients from reaping benefits

Medical errors, the bane of physicians and the cause of some 100,000 preventable deaths each year in the United States, may soon be a thing of the past. New technologies already in use in thousands of clinics and hospitals alert providers to therapies that may harm the patient, such as overly high medication dosages and drug interactions.

As a practicing surgeon who teaches medicine,  I share the sense of urgency of all in my profession who are dedicated to preventing medical errors and ensuring patient safety. So when I was asked recently to co-chair a major national initiative offering free electronic prescribing software — a technology that the Institute of Medicine recommends for every physician — I gladly accepted.

The National ePrescribing Patient Safety Initiative (NEPSI) is a coalition of technology and health care companies, led by Allscripts and Dell, who are dedicated to providing this life-saving technology at no cost to every Drug Enforcement Administration-licensed caregiver in America. It’s a goal that I strongly support because physicians using e-prescribing automatically check prescriptions against patients’ medication histories for potentially harmful allergies and drug interactions, are alerted to incorrect dosages and other problems, and ensure the prescription is provided to the patient without pharmacists guessing at their handwriting.

Recently, however, some critics have questioned whether e-prescribing in general and the NEPSI offering in particular is as helpful as proponents say it is. In an editorial published on BackPage in the February issue of Government Health IT, patients rights advocate Dr. Deborah Peel suggested that NEPSI would sell private patient data and discounted the validity of e-prescribing as an aid for patient safety. Although I applaud Peel’s efforts to protect patient privacy, I believe she is wrong on both counts. More importantly, she and other critics of the technology are spreading misinformation that could potentially prevent millions of patients from reaping the significant benefits of e-prescribing.

To correct the first misperception, I can clarify that NEPSI will never sell any individual patient’s prescription history nor will it divulge any aspect of a patient’s private, protected clinical record. The coalition is barred by law from disclosing personal health information, and its stated aim is to accelerate the adoption of health care information technologies — with e-prescribing as a first step — not to earn money from the offering. Moreover, the technology behind NEPSI is based on an Allscripts system that more than 20,000 physicians use to generate millions of e-prescriptions while maintaining the privacy of their patients.

The second misperception, that the technology is not a solution to medication errors, is also mistaken.  The authors of the Institute of Medicine’s landmark 2006 study, “Preventing Medication Errors,” recommend that “all prescribers should have plans in place by 2008 to implement electronic prescribing.” The Institute of Medicine takes its unambiguous stand on e-prescribing because study after study has shown the technology can prevent medication errors. 

As someone who has studied quality and safety issues for most of my professional life, I strongly advise physicians and health care leaders to take the criticism of NEPSI and e-prescribing with a hefty grain of salt.  Although advocates of patients rights play a critical role in protecting patients from abuse within the health care system, those who use their credentials to criticize the significant safety effects of new technologies do a disservice to the cause they espouse.

Opelka is associate dean for clinical affairs and professor of surgery at the Louisiana State University School of Medicine in New Orleans. He is also a member of  Health and Human Services Secretary Michael Leavitt’s Quality Alliance Steering Committee.


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