Computer aided prescribing: Computer aided prescribing is not panacea but can help

doi:10.1136/bmj.328.7455.1565-c

BMJ 2004;328:1565-1566 (26 June), doi:10.1136/bmj.328.7455.1565-c

Letter

Computer aided prescribing

Computer aided prescribing is not panacea but can help

The first 150 words of the full text of this article appear below.

EDITOR—In his review of computer aided prescribing Fernerreminds us that computers are not a panacea for the eliminationof error.¹ However, our experience shows that electronic prescribingimproves the legibility and completeness of prescriptions² andcan be tailored to reduce particular prescribing risks.³

The perceived safety of computers seems based on interactivealerts. However, interactive alerts can lead to "alert fatigue,"causing busy doctors to override alerts because they seem trivialor irrelevant in the clinical context of individual care. Indeveloping interactive rules alerts with the Wolfson Institutein Birmingham we developed the concept of "contextual alerts,"which alerted clinicians to possible interactions or contraindicationsonly if a real risk of harm existed.

An example is the alert for an interaction between angiotensinconverting enzyme inhibitors and potassium sparing diuretics.Co-prescription of such drugs entails a risk of hyperkalaemia,but most clinicians are aware of this . . . [Full text of this article]

Keith Farrar, chief pharmacist

Wirral Hospital, Wirral CH49 5PE Yfc06@dial.pipex.com

Ann Slee, chief pharmacist

Glan Clywd Hospital, Rhyl LL18 5UJ

Don Hughes, director of pharmacy

Countess of Chester Hospital, Chester CH2 1UL

Peter Marsh, technical director, Carol Makin, clinical director

Wirral Health Informatics Service, Wirral Hospital