Incorporating Medication Indications into the Prescribing Process

Authors

Kevin Kron, Partners Healthcare
Sara Myers, Brigham and Women's Hospital
Lynn Volk, Partners Healthcare
Aaron Nathan, Brigham and Women’s Hospital
Pamela Neri, Brigham and Women’s Hospital
Alejandra Salazar, Brigham and Women’s Hospital
Mary G. Amato, Brigham and Women’s Hospital
Adam Wright, Brigham and Women’s Hospital
Sam Karmiy, Partners Healthcare
Sarah McCord, MCPHS University
Enrique Seoane-Vazquez, Chapman UniversityFollow
Tewodros Eguale, Brigham and Women's Hospital
Rosa Rodriguez-Monguio, University of California, San Francisco
David W. Bates, Brigham and Women's Hospital
Gordon Schiff, Brigham and Women's Hospital

Document Type

Article

Publication Date

4-15-2018

Abstract

Purpose The incorporation of medication indications into the prescribing process to improve patient safety is discussed.

Summary Currently, most prescriptions lack a key piece of information needed for safe medication use: the patient-specific drug indication. Integrating indications could pave the way for safer prescribing in multiple ways, including avoiding look-alike/sound-alike errors, facilitating selection of drugs of choice, aiding in communication among the healthcare team, bolstering patient understanding and adherence, and organizing medication lists to facilitate medication reconciliation. Although strongly supported by pharmacists, multiple prior attempts to encourage prescribers to include the indication on prescriptions have not been successful. We convened 6 expert panels to consult high-level stakeholders on system design considerations and requirements necessary for building and implementing an indications-based computerized prescriber order-entry (CPOE) system. We summarize our findings from the 6 expert stakeholder panels, including rationale, literature findings, potential benefits, and challenges of incorporating indications into the prescribing process. Based on this stakeholder input, design requirements for a new CPOE interface and workflow have been identified.

Conclusion The emergence of universal electronic prescribing and content knowledge vendors has laid the groundwork for incorporating indications into the CPOE prescribing process. As medication prescribing moves in the direction of inclusion of the indication, it is imperative to design CPOE systems to efficiently and effectively incorporate indications into prescriber workflows and optimize ways this can best be accomplished.

Comments

This article was originally published in American Journal of Health-System Pharmacy, volume 75, issue 8, in 2018. DOI: 10.2146/ajhp170346

Recommended Citation

Kron K, Myers S, Volk L, et al. Incorporating medication indications into the prescribing process. Am J Health Syst Pharm. 2018;75(8):ajhp170346. doi:10.2146/ajhp170346

Copyright

American Society of Health-System Pharmacists, Inc.