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10/24/2000

Hospital Tries Handheld ePrescription Device

Kate Traynor

A pilot program started this summer by the pharmacy at Children’s Hospital Medical Center in Cincinnati shows that handheld prescribing devices can smooth the prescription-filling process at outpatient pharmacies. 

The medical center tested a handheld prescribing device manufactured by PocketScript Inc., a local company. Like other electronic prescribing systems, the PocketScript device has the potential to reduce medication errors caused by incorrect deciphering of written prescriptions.

Director of Pharmacy Jack P. Horn, M.S., said the PocketScript device "met my expectations—it did what I thought it would do."

With information about patients' insurance plans programmed into the wireless device, said Horn, prescribers know at the time they select a drug whether it will be covered. In some cases, he said, physicians "may change their selection based on insurance coverage."

The device also warns users about potential drug interactions. By providing information about formularies and potential drug interactions, the PocketScript device can help prescribers make good drug choices the first time, reducing the need for pharmacists to call back.

An obvious bonus of the device, said Horn, is that the pharmacy receives "a very clean prescription, one that’s very legible." With legibility and insurance problems no longer a concern, "the patient isn’t put in the middle and doesn’t have to wait" for the appropriate medication to be prescribed, he said.

Kasey K. Thompson, Pharm.D., director of the ASHP Center on Patient Safety, views electronic prescribing devices—when properly used—as tools that can improve patient safety. In addition to providing legible prescriptions, he said, the devices can support clinical decision-making and provide up-to-date drug information at the point of prescribing.

The medical center's test of the PocketScript device involved two physicians who wrote over 200 prescriptions during the two-month pilot program. Prescriptions to be picked up on-site were dispensed by the outpatient pharmacy. Horn said the physicians sent most of the PocketScript prescriptions to local community pharmacies.

Before the physicians received the devices, the hospital's engineering staff checked to see whether the wireless technology might cause problems with other electronic devices in use. "We didn’t find any interference," said Horn.

Although the PocketScript device can send information directly to a pharmacy's computer, the medical center opted to handle the transmissions by fax.

"Eventually, we hope [prescriptions]…might be electronically transferred," said Horn.

ASHP’s Thompson agrees. "Ideally, we want these [prescribing] systems to…go directly to the pharmacy computer to be verified by the pharmacist."

The PocketScript device helps, but certainly does not replace, pharmacists, said Horn. "It doesn’t do what the pharmacist would do in the way of error-checking, in the way of giving…feedback about therapeutics to the physician."

But by doing some of the mundane albeit important formulary checking now performed by pharmacists, electronic devices like the PocketScript may free pharmacists to spend more time working with patients, said Thompson.

Horn noted, "I think it will make us more efficient if we spend less time tracking down insurance information, and it might make us a little more satisfied with our job."

Horn said his hospital's use of the PocketScript device was reviewed and approved by the Ohio State Board of Pharmacy. PocketScript Inc. reports that its device complies with the requirements of more than 40 state boards of pharmacy, but the company did not confirm that the device has actually been approved for use in these states.