Electronic prescriptions have dramatically reduced medical errors, but despite the widespread proliferation of e-prescribing in healthcare, most systems still do not have a mechanism to cancel orders.
The inability for providers to cancel prescriptions can lead to confusion, unnecessary medications, and patient harm, researchers with the RAND Corporation wrote in a viewpoint for JAMA.
This is particularly problematic for health systems that write prescriptions for pharmacies outside of an integrated health system. While organizations like Kaiser Permanente can easily cancel prescriptions fulfilled inside their network, hospitals that write e-prescriptions to outside pharmacies have virtually no ability to successfully cancel an order.
Updates to meaningful use requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) require EHRs to include a method to cancel prescriptions, but pharmacies are not required to receive those notices. That, coupled with automated alerts from pharmacies reminding patients to refill potentially outdated or canceled prescriptions, creates the possibility for inaccurate prescriptions that could lead to patient harm.
A spokesperson for Surescripts, the nation’s largest e-prescribing platform, which processed 9.7 billion transactions in 2015, told the authors that just one-third of providers and 40% of pharmacies are using EHRs with the capability to cancel prescriptions.
“Years have elapsed since the e-discontinuation standard was defined, and the technological barriers are surmountable,” the authors wrote, adding that federal and state regulars should beef up e-prescribing requirements. “If physicians and physician organizations want to speed up the process of adopting e-discontinuation, they could encourage its implementation from EHRs and pharmacies.”