US Pharm. 2008;33(2):2.
For many seasoned pharmacists,
the days of typing prescription labels on a typewriter, filling out patient
profiles by hand, submitting paper insurance claims, and handling many other
manual administrative chores are distant memories. For more recently graduated
pharmacists, the high-tech world of pharmacy is the only work environment they
know. I don't think there is a pharmacist working today who can honestly say
that technology hasn't changed the way pharmacy is being practiced. And while
today's pharmacists enjoy the ease with which they can type a prescription
label, check drug interactions, update a patient's medical history, submit
insurance claim forms, and robotically fill prescriptions, they should never
lose sight of the fact that the computer chip that runs all their high-tech
equipment is only as good as the information fed into it.
Several decades ago, many
pharmacy pundits predicted that emerging technology would replace the
pharmacist, but obviously that has not happened. A computer has no compassion
and cannot perform e-ffective professional customer services like
face-to-face consultations or making sure patients are complying with and
adhering to their medication therapy. Oh sure, a computer can be programmed to
generate impersonal reminder messages about refills and key drug information,
but it can't offer comfort to a sick patient who needs consoling or talk to
confused patients who may need a little extra help with taking their
medications.
There is much discussion
lately about how e-prescribing is the answer to all of pharmacy's woes,
particularly drug errors. In fact, a spokesperson for General Motors was
quoted in the Detroit News as saying, "The benefits of ePrescribing are
overwhelming in terms of reducing medication errors." I'm not so sure. There
is little doubt that e-prescribing will certainly all but eliminate
prescription errors caused by sloppy physician handwriting, but it does
nothing for prescriptions that are written incorrectly in the first place, and
that seems to be a far bigger issue than illegible handwriting. One New York
pharmacist recently wrote me that she has personally witnessed several errors
with prescriptions that were electronically transmitted. She recalled one
instance in which a very legible electronically transmitted prescription had
the wrong drug prescribed on it. The pharmacist caught the mistake because the
prescription was not consistent with her patient's medical and drug history.
Other problems she's encountered are prescriptions containing "strengths which
do not exist, directions which are terminated before the prescription was sent
electronically [she thinks the directions may have been too long and didn't
entirely fit into that data field], and no indication of whether the physician
prescribed a generic or brand." She has also received prescriptions for
patients who normally do not get their prescriptions filled in her store. She
said that several times patients have arrived to pick up an electronically
transmitted prescription that was not yet transmitted. In such cases, she must
then call the doctor and get the prescription over the phone. The electronic
prescription generally arrives after the patient has already left the store
with the filled prescription in hand. That wouldn't be so bad if it weren't
for the fact that she is paying a transmission fee for every e
-prescription she receives. She concludes: "I haven't found electronic
transmissions to have decreased mistakes or saved time; it just changed the
nature of mistakes being committed and causes me to call the physician for a
different reason. Adding insult to injury, my pharmacy is paying for these
mistakes to be transmitted."
I understand that this example
is one pharmacy in one city, but it makes me wonder how many times this
situation is occurring in pharmacies across the country. There is no question
that technology has its place in pharmacy, but make no mistake about one
thing: It is still no substitute for the e-ffective pharmacist.
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