The Dangers of EMR-Defaulted Prescription Stop  Dates

By HANS DUVEFELT It happens in eClinicalworks, I saw it in Intergy, and I now have to maneuver around it in Epic. Those EMRs, and I suspect many others, insert a stop date on what their programmers think (or have been told) are scary drugs. In my current system all opioid drug prescriptions fall into this category. For a short term prescription that might perhaps be a good idea but for a longer-term or occasionally needed prescription it creates the risk of medical errors. In Epic there is a box for duration, which is very practical for a ten day course of antibiotics. If I fill in the number 10 in the duration box, the medication falls off the list after 10 days. This saves me the trouble of periodically cleaning up the list. But if I prescribe three oxycodone tablets a day for a patient with inoperable back pain and follow the convention of saying for 30 days or 28 days, that creates a problem: If my patient is careful not to take more pain pills than absolutely needed and the prescription indicates 28 or 30 days duration, the text on the prescription will read for up to 28 days or for up to 30 days. That language actually suggests they’d better hurry up and finish it and not have any pills left over. The other consequence is that if my patient doesn’t call for a refill until day 32, the medication has already disappeared from their medication list and cannot easily be “restarted”. I have occasionally restarted/re-issued a medication f...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Physicians EMR Hans Duvefelt Medical Practice prescriptions Source Type: blogs