Letter to the Editor
We read the editorial by Robert Pearce and Ian Whyte with interest.1 We agree that electronic medication management is a step forward in access to prescribing and administration records with capability for passive and active decision support.
Electronic medication systems have positively impacted the antimicrobial stewardship post-prescribing rounds conducted at our health service. At the click of a button, we get a snapshot of all current hospital inpatients prescribed an antimicrobial. This significantly improves efficiency. Also, electronic approval rates for restricted antimicrobials have increased significantly related to the embedded clinical-decision support that alerts prescribers when a restricted antimicrobial is being prescribed. We recognise, however, that this has not removed the need for a separate electronic approval system for antimicrobials, or antimicrobial stewardship post-prescribing rounds.
We acknowledge that the challenges of implementing electronic medication management include developing a clear process of local stakeholders having input and being able to provide timely feedback on local improvements to generic software. For antimicrobials, we have recommended changes on common dosing and turning on of some alerts that were initially turned off to minimise alert fatigue.
Electronic medication management also offers new opportunities to practise antimicrobial stewardship. It is easy and fast to identify patients on any antimicrobial, not just the restricted ones that have made it into the electronic antimicrobial approval system. This allows the scope of antimicrobial stewardship teams to potentially expand to review prescribing practice for non-restricted antimicrobials rather than traditionally relying on usage data.
Antimicrobial stewardship physician
Antimicrobial stewardship pharmacist
Lead antimicrobial stewardship pharmacist
Eastern Health, Melbourne
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