News Brief: RAND looks at standards for e-prescription systems

A team of researchers from the Santa Monica, CA-based think tank RAND is working on a set of standards for electronic prescription writing. The group reported in March that there are several issues that need to be addressed, including:

  • privacy and security of patient data;
  • full disclosure of the criteria used to label drugs;
  • full disclosure of funding source for product;
  • the quality and completeness of the data on which assessments of drug interactions or drug safety are based;
  • user interface design.

An independent panel of nationally recognized experts is providing guidance in developing the standards and will review the final recommendations. The panel, chaired by Donald M. Berwick, MD, president of the Institute for Healthcare Improvement, also includes leaders from medicine, nursing, pharmacy, medical informatics, health policy, and law.

In the last three years, dozens of new electronic prescribing products have appeared on the market, including programs for hand-held devices, Internet-based applications, and systems designed to interface with office management software and electronic medical records.

Some of these systems simply provide printed prescriptions; others recommend drugs based on a patient’s insurance coverage or warn about potentially dangerous drug interactions. The most sophisticated systems suggest drugs tailored to the patient’s medical condition and even initiate lab tests to monitor the patient’s response to therapy.

Whether this powerful decision-support technology actually improves patient care depends on how it is implemented and how it is used, says RAND’s initial report on the topic. For example, the order in which drug names appear in a menu of choices or the wording in alert screens may bias doctors’ drug choices or introduce new types of prescribing errors. The RAND team currently is classifying existing systems and will choose six to 10 exemplary systems that span the range of available features. In-depth review of these systems will be the basis for developing standards, which should be ready for dissemination within 12 months.

This study is being underwritten by a grant from Pfizer Inc. For more information, including a listing of the expert advisory panel members, visit the project web site at