e-Prescribing resources

Excellent discussion!

Kelly, your PhD student may find this recent ISMP US article entitled "Is An Indication-Based Prescribing System In Our Future?" helpful in your review, which also references this NEJM article and others:
Schiff GD, Seoane-Vazquez E, Wright A. Incorporating indications into medication ordering—time to enter the age of reason. N Engl J Med. 2016;375(4):306-9.

Sincerely,
Alice
ISMP Canada

Great discussion thus far on including the indication when writing a prescription.

This article looks at whether entering an indication can prevent wrong patient errors when using CPOE.

Click here to access the article.

Entering orders on the wrong patient is a technology induced error that many of us are familiar with as we are faced with interruptions and multi-tasking. As in many of the cases reported here - clinicians had more than one patient screen open. Strategies to prevent these errors are imperative to improve patient safety. Adding indications appears to prevent errors.

Lisa

awesome!

I have all the literature I did both for my scoping and for my main review....plus all the results of my own de novo investigations. If it would be helpful to chat, please let me know.

In the domain model for the Medication Profile that I've developed, it uses the information that is provided from the activities in the process....So if a prescriber has given an indication, it uses that information; it doesn't "require" it. However, the requirements analysis showed that this is an extremely useful piece of data, hence I'm encouraging systems to encourage their users to provide it
The dynamic model also has a whole set of rules on how to process information using both generic and brand names; the choice of how to display that back to users is an implementation decision (although I have lots of thoughts to offer on that).
And in all cases, having the metadata available (who, what, when) for any piece of data available through drill down is considered critical. In the evaluation work I did, that level of information was very firmly endorsed by the evaluators.

This is great--we're having this exact discussion in our research team right now. Our interest is in *how* information such as the indication (AKA "reason for use") gets used to make decisions about medications. This includes decisions by pharmacists, physicians and patients. Our work is funded through the CIHR SPOR program so we have patients on our research team--something that highlighted for us just how critical this field is. Specifically, while pharmacists and family physicians can make an educated guess (or google search, as it happens) about why a medication is being used, patients require a clear, easy to understand explanation. I think historically we've focused on how information gets communicated between MDs and RPhs. However, in order to provide patient's with *useful* access to information through our expanding EHRs, this field is becoming a must have rather than a nice to have.

Of note, my PhD student is starting a scoping review of the literature on the effects of adding the reason for use this month. If you have any good articles we should be aware or have any guidance, please let me know.