Friday, June 19, 2009

Meaningful Use: Your prescription shouldn't have to look like this

I spent a year studying medication safety at the Institute for Safe Medication Practices, the nation's only patient safety organization devoted solely to medication error prevention and safe medication use. So I'm always on the lookout for ways to help others see what I learned to see.

My friend had a friend-of-a-friend deliver a load of pine straw to her home the other day. The delivery man left an invoice, and my friend asked me to interpret the name of the company so that she could write a check.

Take a look and see what you think.

I guessed "Chevrolet" (even though it seemed like a weird name for a handyman service.) My friend frowned. She's a middle-school math teacher, and she's detailed-oriented. "Leave it blank," I suggested, "and mail it. Mr. Pinestraw can fill it in." More frowning. (This suggestion was clearly not welcomed by my friend, one of the most reliable people I know, someone who dots her i's and crosses her t's and is not in the habit of leaving things blank.)

Several days later, my friend mentions she's going to drop the check for Mr. Pinestraw off, having finally tracked him down via telephone and clarified the name. "Cherokee!" she says triumphantly!

To average Walmart shoppers like myself, health policy and IT discussions about how $20 billion dollars in economic stimulus funds are going to be put to meaningful use sound a lot like Charlie Brown's teacher: "Waoao waoaoa waoaoa wah woaoao."

So, let me draw on the med safety expertise and call out a few suggestions for how I think monies spent for meaningful health IT should be visible to healthcare consumers:

1. People who prescribe medications should use a system more sophisticated than the pine straw delivery guy's to communicate high-stakes drug information. 1,400 commonly prescribed drugs have names that look-alike or sound-alike. People can, and do, die when drug names are confused with one another.

2. Pharmacies should be able to receive prescription data in a format that does not require the tenacity of a middle-school math teacher on summer holiday to decipher.

3. Your electronic medication history--housed with your physicians, pharmacy, and any consumer portal you choose--should move seamlessly into hospital data repositories and be accessible, with your consent, during planned and emergent encounters.


mlee said...

love it.
"Waoao waoaoa waoaoa wah woaoao."

Jerry Fahrni said...

I think you've done an excellent job of breaking the issue down to it's most fundamental parts. I've been a "hospital pharmacist" for the past 12 years and have seen more than my share of poorly written chart orders. The time, energy and effort spent clarifying these orders in extraordinary. Thank you for your wonderful insight.

Reality Rounds said...

No one should ever have to interpret a written medical prescription ever again. It is archaic. If you are interested in a real time drug error (that happened to me :(), email me and I will tell you the story for you to deconstruct and post. Thanks for all you do.

Kairol Rosenthal said...

I'm a young adult cancer patient and writer. Tis the season to get hit up with cnacer walk, bike, run-a-thon requests. Not that I don't think cancer research is a wonderful idea, but I often wonder why nobody is having walk-a-thons to raise awareness about handwashing and illegible prescription writing. Both claim more lives per year than breast cancer.

Your blog is fantastic. I'm linking it to my blog roll. Feel free to link to mine.


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