Discussions on health care reform that are focused on areas where large cost savings can potentially be realized frequently turn to medical record systems, with this question commonly being asked: How can the system of compiling and storing relevant patient, treatment, prescription and other relevant information be streamlined and updated to make it more efficient and cut costs?

An interesting study recently appearing in the Journal of General Internal Medicine examines the cost efficiencies of a newer and more sophisticated electronic medication prescribing system as compared with older electronic processes and the handwritten practices still quite common with many physicians. Central to the study was examination of the effect of switching systems on the rate of medication errors resulting from prescription mistakes.

Many medical facilities are quite motivated to experiment and transition to new systems, given the substantial monetary incentives for doing so that have been established by the government. The study just released concludes that, while adopting a more sophisticated system does eventually lead to fewer prescription errors, it also results in increased errors over the short term.

Rainu Kaushal, one of the study's authors, says that the results "speak to the fact that transitioning is very, very hard" and that many physicians are resistant to changing. Of those who responded to a follow-up research survey, only a minority stated that they believed the newer process improved patient safety. Forty percent said they were not satisfied with the program.

Kaushal understands the frustration of being "on the receiving end" of new and time-consuming learning activities, but she says that the results do show prescription errors dropping over time for facilities that set up the new process. In the study data examined, errors dropped overall from 35.7 per 100 prescriptions at the outset to 21.1 errors at three months out and 12.2 mistakes one year following set up.

And improvements "happened immediately and were sustained" in the area where most errors commonly occur, namely, with doctors using abbreviations that are misunderstood by pharmacists.

Kaushal strongly recommends electronic updating of prescribing systems, both for the sake of accuracy and cost savings. She says that the benefits "far outweigh" the disadvantages.

Related Resource: Wall Street Journal, "Study: Transition to Newer E-Prescribing Systems May Threaten Safety" May 27, 2011