I’m probably the only person here who is going to feel this way, but I think this whole ePrescribing shit is bad juju.
Sure, doctors obviously lack some gene to write well, but ePrescribing is going to end up killing more people than saving.
Why? Take your typical doctor. Brilliant medical mind, but can barely point-and-click. Now throw that doctor in front of a computer with a tiny little drop-down box that has such winners as:
In tiny tiny font all right next to each other in the drop-down drug selection menu. Ever click on the wrong thing on the screen? Yeah, I think you can see where i’m going with this. Uh-oh! Here comes hydralazine 25mg 1 q8 prn itching come racing into our fax machine. Uh-oh! That patient just died! Uh-oh! That pharmacist was a major dumbass (*ahemwalgreensahem*)
To make matters worse, the doctor probably has someone talking to them while they are trying to place that little mouse pointer on exactly the right drug in the huge huge list thats scrolling down past the bottom of their screen. Click on the wrong drug, type in their magical password so it prints their signature on the dotted line, and blam-o, your pharmacist just saved you from lawsuit city. Now if this doctor has a 21″ flatpanel that drop-down box is pretty damn big, and the click-space between similar sounding drugs is pretty big too, but what about PDAs? Now that big screen is a tiny tiny little screen with a tiny tiny little stylus that you select the drug from a tiny tiny little list. Fun shit technology is.
Now I know you all are probably thinking; “Gee! This happens with paper-and-pad Rx’s all the time too!”. However, using a mouse does not involve 20+ years of muscle memory. Ever drive on autopilot to the office and wonder “why did I come here?”. Any schmo doctor can write out Amoxicillin 500 tid x10d #30 while talking, doing surgery, and taking a dump. They have been writing Drug X with Sig X and Quanity X for 20 years. Drug matches Strength matches Quanity. If they error, they error (you hope) on the side of just writing the wrong drug and a safe sig to go with that drug. Sure, the patient is getting the wrong drug but I’d rather have him get the wrong drug and a correct sig for that wrong drug than the wrong drug and an overdose sig intended for the correct drug. Make sense? Confusing isnt it.
What about forgeries? We all know Windows is a exploit riddled piece of crap operating system, but 99.999% of ePrescribing is written for it. Send an office staff a little happy email with a virus, and you have an endless supply of vicodin and soma that you can send to ANY pharmacy and have it be “legit”. You think a minimum wage front-end office staff girl is going to question Norco 10/325 #240 1 q4 prn pain with 5 refills when it clearly shows that on their computer screen? Hell, I bet the software even helps them with the sig and everything! At least with phone-ins you get a gut feeling when its a phony by the way they call it in (or its a voice you dont recognize) or the red flags with a stolen Rx pad.
To make matters worse – patients come waltzing into your store expecting their Rx to be ready (because doctor was typing it in while they were at the office an hour ago) only to have it NOT be at your store because their ePrescribing auto-fax software screwed the pooch (or they have your fax number in wrong). So it takes a phone call from you to a dumbass at the doctors to get a verbal. All when 2 extra seconds and a hard-copy Rx is all thats needed. Horrible, absolutely horrible.
Now I know all the doctors at home will say “But it makes reviewing my patients medication SO much easier”. Thats great, but does your software talk with the patients cardiologists software? How about the patients neurologist who prescribes Tegretol 1600mg/day and you’re giving them Nizoral 200mg qd (I caught that one today, +1 for me!). ePrescribing is all fine and dandy, but if your records are going to be electronic, at least interlink them with other doctors offices (oh, I can see the HIPAA police frothing at that one). Of course the same could be said about independant pharmacies as well, but at least we talk to each other on a regular basis..
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