Evaluation of features to support safety and quality in general practice clinical software

• Michelle Sweidan, and others
• BMC Medical Informatics and Decision Making

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24 May 2011Electronic prescribing (e-prescribing) offers an opportunity to improve the quality, safety and efficiency of health care and is now the norm in many countries. There is evidence to show that e-prescribing (often with clinical decision support) is associated with a reduction in medication errors and incomplete or unclear orders, improved drug allergy detection and greater adherence with clinical practice guidelines. There are however also reports of unintended negative consequences of e-prescribing, for example unfavourable effects on workflow and the introduction of new types of errors.

Software systems for e-prescribing have been available for two decades, however standards and certification processes for these systems have lagged behind development and use of the software. Currently there is little information for funders or users of these systems to assess how effectively a system supports healthcare safety and quality.

In Australia, general practitioners (GPs) have been using clinical software systems that include e-prescribing for more than 15 years, with rapid uptake encouraged by government incentives in the 1990s. These systems have been developed in an unregulated environment, with little evaluation of their impact on clinical practice or health outcomes. We wished to find out if current systems include features that facilitate improved patient safety and care, with a focus on quality use of medicines. Quality use of medicines is the judicious, effective and safe use of medicines, and in terms of clinical software functionality it encompasses the entire medication management process.

Authors: Michelle Sweidan, Margaret Williamson, James F Reeve, Ken Harvey, Jennifer A O'Neill, Peter Schattner and Teri Snowdon.