Electronic Medical Records for Patient Safety: PDAs & Personalized Prescribing
At a recent professional conference, JCAHO Senior Vice President Paul Schyve, MD, spoke strongly of the need to improve patient safety in hospitals, citing electronic medical records as one tool available for such improvement. Digitally recorded orders significantly reduce prescription errors, and provide immediate information at the bedside. According to a recent study by the Institute of Medicine, as many as 7,000 deaths per year were caused by prescription error in the United States alone.
Several companies now offer digital prescription services, and the personal digital assistants (PDAs), which support such work, have become ubiquitous at institutions like Jefferson. Developments in the field are being reported to health consumers as popular news, as well, by mainstream news sources like ABC.
The ability to prescribe with the tools at hand to know which drugs are permitted by a patient's HMO, or to check known interactions of drugs in the patient's complete drug profile with a possible new prescription is invaluable. Though current participation by practicing physicians is low, leadership from the JCAHO and HMOs is expected to result in dramatic changes in the near future.
The new environment of the EMR will also support the growing movement toward personalized prescribing, based on the science of pharmacogenomics (aka pharmacogenetics). DNA-based tests can identify individual dosage requirements for drugs, thereby significantly increasing both safety and efficacy. Recent estimates place the number of deaths due to adverse drug reactions at over 100,000 per year in the United State. Research on this technology is moving rapidly in both academic medical centers and in the pharmaceutical/biotechnology industry.
For further information about developments in pharmacogenomics, see "Personalized prescribing," The Scientist 15(12):10, June 11, 2001, and The SNP Consortium Ltd., "Genotyping technology products user requirements survey."
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