National quality and safety standards needed for General Practice prescribing software
3 May 2011
Australia needs national standards for general practice prescribing software to help vendors ensure their products support quality and safety in prescribing, according to a study conducted by NPS published in the journal BMC Medical Informatics & Decision Making today.
National standards would also ensure a guaranteed minimum level of clinical functionality which clinicians could expect to find in any system, according to NPS CEO Dr Lynn Weekes.
“Given the widespread use of electronic prescribing systems in day-to-day practice, it’s essential these systems meet key quality and safety criteria. At a minimum, general practice prescribing systems must support quality use of medicines and should be purposely designed and populated with decision support content which is independent, evidence-based, accurate, up-to-date and locally relevant.”
“The development of clear national guidelines and standards would no doubt help improve the quality and safety of e-prescribing systems in Australia.”
The study, which was carried out in 2008, reviewed seven commonly-used prescribing systems against a prioritised list of prescribing software features which were rated based on their impact on patient safety, quality of care, usefulness to the clinician and usefulness to the patient.
It found that some important safety features were included in most systems including alerts for drug-drug interactions, drugs in pregnancy and allergies. When creating or opening a new patient record, all systems warned the user if there was another patient with the same name in the system.
However clinical decision support for prescribing was found to be highly variable, with little or no support for harmful dosage regimens or for safety issues related to specific products, such as recent warning issues by the TGA. No system provided access to information from either the Australian Medicines Handbook or Therapeutic Guidelines – two key evidence based resources for Australian medicines.
Many of the systems required practitioners to select medicine names from long lists of similarly-named products, potentially increasing the risk of errors being made when prescribing. Information resources for patients were also found to be variable and limited in some systems.
Since the study was conducted, most of the software vendors indicated that they would make some changes to improve their products, however without national standards, Dr Weekes says gaps and inconsistencies would continue to exist.
“At the moment, there are major differences between systems in terms of what is considered important for quality and safety in prescribing. Government, professional bodies and the software industry all have a role to play in developing national standards to help ensure clinicians have the appropriate support structures in place when prescribing medicines.”
“In the absence of national standards, the features identified in the study could be used by software developers to improve the functionality of their systems,” Dr Weekes said.
A number of specific recommendations are made in the study report. For a copy of the full article, visit http://www.biomedcentral.com/bmcmedinformdecismak/
Independent, evidence-based and not-for-profit, NPS enables better decisions about medicines and medical tests.We are funded by the Australian Government Department of Health and Ageing.