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Computers can make prescribing safer

We wish medical schools taught penmanship along with physiology, pathology and pharmacology.

Instead, people make jokes about the illegibility of the typical doctor's scrawl. But when the pharmacist can't read your prescription, your physician's bad handwriting is no laughing matter.

The Board of Trustees of the American Medical Association has gone on record stating, "Physicians are mostly responsible for prescribing errors . . . . Errors are often introduced by illegible handwriting, misspelling and the use of inappropriate abbreviations in written orders."

The overwhelming majority of prescriptions are still written in Latin code. Don't believe us? Just check your next prescription. Chances are good that you will find terms such as "P.O.," "b.i.d.," or "p.r.n." Breaking this bad habit has proved almost impossible for many doctors.

The Board of the AMA goes on to recommend, "Written drug or prescription orders (including signatures) should be legible. Physicians with poor handwriting should print or type medication orders."

Misinterpretation of an illegible prescription can lead to dispensing errors with potentially tragic consequences. Ask any pharmacist if he or she has ever made a mistake in dispensing and the answer is likely to be yes. Too often these errors are caused by time pressure and poor penmanship. They can result in a patient getting the wrong drug or the wrong dose.

Fortunately, this is one problem technology can solve. On-line prescribing is becoming a reality. A computer in the doctor's office links directly to the computer in a pharmacy. Even before the prescription is transmitted, the doctor or nurse can screen for drug allergies and interactions.

They can even verify the dose. You'd be amazed how often a pharmacist has to call the doctor's office to ask, "Doesn't Dr. Smith mean one teaspoon twice a day rather than four times a day?"

Once the physician is sure that all details are correct, the prescription is transmitted electronically in seconds to the pharmacy computer. This alerts the pharmacist that a patient will be coming in to pick up the prescription so that it can be ready with no waiting.

The advantage over a phoned-in prescription or a fax is less room for error. In a noisy pharmacy it can be difficult to distinguish between similar-sounding drug names. Xanax and Zantac are a classic problem. So are codeine and Cardene. And a fax of a handwritten prescription can just make an illegible scrawl harder to read.

Another advantage of the electronic prescribing system is verification. The doctor can determine if the patient has picked up the prescription and is getting refills on time.

E-mail among patients, pharmacists and physicians can improve communication, eliminate phone tag, and provide patients access to follow-up information on side effects and outcome.

It's time doctors gave up their pens and prescriptions pads. Computers can revolutionize patient charts and doctor-patient communications as well as prescriptions.

Picking up your pills

Question: When is the best time to get my prescription filled? I hate waiting.

Answer: Pharmacists are busiest on Mondays and Fridays. Rush hours are also bad _ 9 to 10 a.m. and 4 to 7 in the afternoon. Lunch hour also can be very busy.

To avoid the crush of other customers, pick up your prescription late Saturday or any time on Sunday.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their latest book is The People's Pharmacy: Completely New and Revised (St. Martin's Press).

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