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Issues with E-Prescribing Can Lead to Liability Exposure

On Behalf of Cranwell & Moore P.L.C., Attorneys at Law Sept. 9, 2018

Electronic prescribing has been part of the healthcare scene since 2003, and most medical practices and pharmacies use this system. E-prescribing was developed to reduce prescription errors and increase patient safety. However, issues still exist, which may cause harm to a patient and open the provider to liability

Alert fatigue

E-prescribing programs are equipped with alerts. For example, when a doctor prescribes a medication and is going to use the system to send it to the pharmacy, he or she may be confronted with a warning that this medication may interact with one that was prescribed for the patient by another physician. The drug interaction list is extensive, and the system generates warnings so often that doctors can develop “alert fatigue.” However, if the alert is ignored, the patient could be harmed, and the doctor may be found negligent.

Undetected errors

Because of unclear, inaccurate or missing information, pharmacists interact more with the provider about e-prescriptions than they do about those that are handwritten by the doctor. A study focused on prescription errors revealed that one in 10 e-prescriptions contained at least one medication error. Pharmacists cannot always detect such mistakes and, once again, the patient may be harmed as a result.

Software design problems

Poor screen design, automatic fill-in features and confusing drop-down menus have been cited as possible sources for errors. The system also allows for bundling, or the sending of a large number of e-prescriptions at one time, which causes tension on the pharmacy end since it requires verification of prescriptions and a rush to complete the filling instructions.

System failure

Incompatibility between software designs as well as system failure can negatively impact pharmacy workflow, which, in turn, may adversely affect patient care.

Liability issues

Just as with diagnosis errors or poor illness management, a doctor or pharmacist may be found negligent if he or she makes an error in issuing or dispensing an e-prescription and the patient suffers harm. Electronic prescribing has solved certain patient safety problems, but the technology has created the potential for new errors. Medical staff and pharmacists must check and double-check all e-prescriptions out of an abundance of caution.