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Decision support

ePrescribing can support the entire medicines use process, enabling medications to be managed electronically from prescribing through to supply and administration. The resources here, although no longer maintained, may be useful to trusts planning ePrescribing implementations.

This section contains information about how to make best use of ePrescribing decision support, avoiding both known risks and over-alerting.

Allergy checking document published - March 2010

Failure to check whether a patient has an allergy prior to prescribing a medicine is arguably an unforgiveable medical error. It's not surprising, then, that allergy checking is thought by many clinicians to be one of the key elements of decision support that should be available within an ePrescribing system.

Introducing allergy checking is not, however, a simple task and there are a number of issues that need to be addressed if it is to operate successfully and in a way supported by system users. To this end, NHS Connecting for Health held a workshop in October 2009 at which delegates were asked to consider how allergy checking should be structured in order to best support day-to-day clinical practice and patient safety.

A document was developed  incorporating this input and included on the ePrescribing web pages in order that further feedback could be gained and a consensus achieved. Following this process  an updated version of the document (PDF, 891Kb) is now available.

Hazard framework for ePrescribing decision support - February 2010

NHS Connecting for Health has published a hazard framework for ePrescribing decision support (PDF, 108Kb).

Clinical decision support broadly refers to the provision of clinical and patient-related information to enhance patient care. Such information needs to be filtered intelligently and presented at the right time to the appropriate person. It can be as simple as the provision of a drop-down list to reduce selection errors to more complex information and support such as alerts for drug-drug interactions.

Clinical decision support can facilitate improvements in patient safety but it may also have unforeseen limitations. The functionality therefore needs significant assessment prior to, during and after implementation to ensure that it does not increase rather than decrease the risk of errors. It's here that the hazard review guidelines should prove useful.

The guidelines were developed following a structured process involving a literature review and talking to experts in the field. Draft guidelines were then published on the ePrescribing web pages, at which point further feedback from interested parties was invited.

Dose range checking guidelines - October 2009

Dose range checking is a type of decision support functionality which, as part of an ePrescribing system, can support the prescription of appropriate doses of medicines and other therapies. It can be particularly useful when dealing with children and other patient groups where factors like age and weight introduce more complexity. 

These dose range checking guidelines (PDF, 95Kb) were developed with input gained from a range of NHS organisations and professional bodies. They aim to:

  • define the background of dose range checking as a component that will be used nationally to support hospital-based ePrescribing.
  • scope the spectrum of concepts that could be considered in the implementation of dose range checking functionality in ePrescribing systems.
  • provide a framework for the prioritisation of dose range checking elements.

The guidelines will be of particular relevance to staff who have an involvement in developing ePrescribing systems, and third party data suppliers. However, they may also be of interest to those with an interest in ePrescribing and medication safety generally, including: healthcare staff such as doctors, nurses and pharmacists; other NHS trust employees (e.g. IT staff); professional bodies and specialty-specific associations; and NHS agencies such as the NPSA.