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    Thursday, August 10, 2006

    e-Panacea: From that article a while back about the inadvertent breach of e-security by a computer consultant:

    'E-prescribing is a leading sector for electronic health records,' says Swire. 'Improper medication lists are by far the biggest source of medical errors -- there's drug-interaction problems, there's incorrect dosage problems. The single biggest saving from e-health is from e-prescriptions.'

    It's true that keeping track of prescription changes is one of the most difficult things to do today. A patient's insurance may switch brands to save money, a consultant may switch dosages, the patient and his doctor may forget to update his medication list. But does this result in life-threatening, or even morbidity-inducing medical errors? The most common is probably having a different brand name, but if a patient takes Accupril 10mg once a day at home, and is given lisinopril 10mg once a day at the hospital, would it make much of a difference? What if he takes Accupril 10mg once a day, but gets 5mg once a day at the hospital because he forgot to update the list he carries in his wallet, or his medication list in his paper chart didn't get updated when the dose was increased. Would it make any difference? Not really.

    What is important, is avoiding overdosing or avoiding drug interactions. Computers can certainly avoid overdoses by allowing only certain limits within a dosage range for any given drug. They can help avoid drug-to-drug interactions by giving automatic alerts. But I doubt they would do much to avoid what amounts to transcription errors. Those are dependent on data entry, which is dependent on the human hand (and mind.)

    But again, those kind of errors aren't really significant errors. They're the equivalent of forgetting to turn on your turn signal when making a turn, as compared to turning into an oncoming car. Unfortunately, patients often don't see it that way. Give someone the lower dose of their heartburn medication instead of the higher dose and they'll label you as incompetent.

    posted by Sydney on 8/10/2006 08:33:00 AM 0 comments


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