Assessing automated product selection success rates in transmissions between electronic prescribing and community pharmacy platforms

Handing Off Electronic Prescription Data From Prescribers to Community Pharmacies: A Qualitative Analysis of Pharmacy Staff Perspectives

OBJECTIVES

The aims of the study are to understand the process of how community pharmacies handle electronic prescriptions (e-prescriptions) and learn about different errors or potential errors encountered.

METHODS

Fifteen remote, semistructured interviews were conducted with community pharmacy staff. Interview analysis was done with two adapted Systems Engineering Initiative for Patient Safety methods to understand the workflow and an affinity wall, which led to key words that were tallied to understand the frequency of different issues.

RESULTS

Data entry in community pharmacies is a process that varies based on the different software platforms receiving e-prescriptions. Data entry of a medication product is typically a human-reliant process matching an e-prescription with an equivalent medication product. Current automated safety supports focus on matching the dispensed medication to the medication chosen at data entry. Substitutions may be required for a variety of reasons, however, pharmacists' comfort and permissions in doing so without provider involvement fluctuates.

CONCLUSIONS

Prescription errors remain that could be prevented with additional support at the data entry step of e-prescriptions. Few studies demonstrate where these errors originate and what role current technology plays in contributing to or preventing these errors. Future work must consider how these matches between prescribed medications and pharmacy fulfilled medications occur. There is a need to identify potential tools to support data entry and prevent medication errors.

Medication safety incidents associated with the remote delivery of primary care: a rapid review

OBJECTIVES

The COVID-19 pandemic triggered rapid, fundamental changes, notably increased remote delivery of primary care. While the impact of these changes on medication safety is not yet fully understood, research conducted before the pandemic may provide evidence for possible consequences. To examine the published literature on medication safety incidents associated with the remote delivery of primary care, with a focus on telemedicine and electronic prescribing.

METHODS

A rapid review was conducted according to the Cochrane Rapid Reviews Methods Group guidance. An electronic search was carried out on Embase and Medline (via PubMed) using key search terms 'medication error', 'electronic prescribing', 'telemedicine' and 'primary care'. Identified studies were synthesised narratively; reported medication safety incidents were categorised according to the WHO Conceptual Framework for the International Classification for Patient Safety.

KEY FINDINGS

Fifteen studies were deemed eligible for inclusion. All 15 studies reported medication incidents associated with electronic prescribing; no studies were identified that reported medication safety incidents associated with telemedicine. The most commonly reported medication safety incidents were 'wrong label/instruction' and 'wrong dose/strength/frequency'. The frequency of medication safety incidents ranged from 0.89 to 81.98 incidents per 100 electronic prescriptions analysed.

SUMMARY

This review of medication safety incidents associated with the remote delivery of primary care identified common incident types associated with electronic prescriptions. There was a wide variation in reported frequencies of medication safety incidents associated with electronic prescriptions. Further research is required to determine the impact of the COVID-19 pandemic on medication safety in primary care, particularly the increased use of telemedicine.

Creating Data Standards to Support the Electronic Transmission of Compounded Nonsterile Preparations (CNSPs): Perspectives of a United States Pharmacopeia Expert Panel

The perspectives of the Compounded Drug Preparation Information Exchange Expert Panel of the United States Pharmacopeia (CDPIE-EP) on the urgent need to create and maintain data standards to support the electronic transmission of an interoperable dataset for compounded nonsterile preparations (CNSPs) for children and the elderly is presented. The CDPIE-EP encourages all stakeholders associated with the generation, transmission, and preparation of CNSPs, including standards-setting and informatics organizations, to discern the critical importance of accurate transmission of prescription to dispensing the final product and an urgent need to create and adopt a seamless, transparent, interoperable, digitally integrated prescribing and dispensing system benefiting of all patients that need CNSPs, especially for children with special healthcare needs and medical complexity (CSHCN-CMC) and for adults with swallowing difficulties. Lay summary: Current electronic prescription processing standards do not permit the complete transmission of compounded nonsterile preparations (CNSPs) from a prescriber to dispenser. This lack creates multiple opportunities for medication errors, especially at transitions of care for children with medical complexity and adults that cannot swallow tablets and capsules. The United States Pharmacopeia Expert Panel on Compounded Drug Preparation Information Exchange aims to reduce this source of error by creating ways and means for CNSPs to be transmitted within computer systems across the continuum of care. Twitter: Digitizing compounded preparation monographs and NDC-like formulation identifiers in computerized prescription systems will minimize error.