Abstract
Study on Barriers to Implementing Electronic Prescribing from the Pediatric Emergency Department
Pediatrics (Evanston), v 144(2_MeetingAbstract), pp 1-40
01 Aug 2019
Abstract
Purpose Electronic prescribing (e-prescribing) is an important core measure of the meaningful use rules as indicated by HITECH ACT in 2009. E-prescribing has other benefits as well including increased patient safety, improved communication with pharmacies, decreased pharmacy wait time leading to improved patient satisfaction. The objective of this study is a to determine the current rate of electronic prescribing from the Pediatric Emergency Department (PED) upon discharge and evaluate any barriers to the process. Methods There are 19 attending physicians that work in the PED. Trainees from various residencies rotate through the PED. A survey was sent to all staff attending and trainees that work or rotate through the Pediatric Emergency Department to obtain the current opinions and knowledge about electronic prescribing. A query of the electronic health record was obtained to determine the current rate of electronic prescribing from January 2017 to January 2018. Results Out of 44,105 prescriptions that were prescribed from the PED from January 2017 to January 2018 only 273 (0.006 %) were e-prescribed. When asked, participants responded that they never e-prescribe from the PED at 53.6 %, often at 5.8 % and always at 3 %. Participants responded that they agree e-prescribing will increase patient satisfaction at 52.2 % and are likely to change their prescribing habits at 32.4 %. Participants responded that finding the correct pharmacy is a significant barrier to e-prescribing at 84.1 %. Participants responded that excess of EMR alerts is also a barrier to e-prescribing at 69.1 %. Participants provided comments at the end of the survey such as "what if the patient goes to wrong pharmacy", "time necessary to identify correct pharmacy", "lack of efficiency", "changing plan by staff", "checking the prescription as I am signing it is my personal check against prescribing errors." Conclusion There are significant barriers to initiating a move towards electronic prescribing from the PED. The most significant barriers are finding the correct patient pharmacy on the electronic health record (EHR), who will be responsible to obtain the pharmacy information from the patient or family and input the pharmacy into the EHR and physician resistance to change. We also found during this investigation that prescriptions sent electronically are not included on our routine discharge paperwork. This significantly hinders discharge planning by nursing who uses this paperwork for discharge instructions and is confusing to patients and families who may not recall prior discussions. Our next step is to implement quality improvement methodology to address current barriers and increased our rate of e-prescribing.
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Details
- Title
- Study on Barriers to Implementing Electronic Prescribing from the Pediatric Emergency Department
- Creators
- Dorota Pazdrowska-Chowdhry - Riley Hospital for Children
- Publication Details
- Pediatrics (Evanston), v 144(2_MeetingAbstract), pp 1-40
- Publisher
- American Academy of Pediatrics
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Pediatrics
- Other Identifier
- 991022160518404721