Implementing an E-Prescribing System in Outpatient Mental Health Programs
- First Online:
This study describes the implementation and evaluation of an electronic prescription ordering system and feedback report in three community-based mental health outpatient agencies and the usefulness of the system in improving psychiatrists’ prescribing behavior. Using the e-prescribing system as a data collection tool, feedback on evidence based prescribing practices for patients diagnosed with schizophrenia spectrum disorder or major affective disorder was provided to agency directors and prescribers via a monthly report. The results of the project were that e-prescribing tools can be installed at a reasonable cost with a short start up period. Although the feedback intervention did not show a significant reduction in questionable prescribing patterns, we should continue to investigate how to best use HIT to improve safety, reduce costs, and enhance the quality of healthcare. A better understanding of what prescribers find useful and the reasons why they are prescribing non-evidenced based medications is needed if interventions of this type are to be effective. Given the availability of administrative claims data and electronic prescribing technology, considerable potential exists to provide useful information for monitoring and clinical decision making in public mental health systems.
KeywordsE-prescribing Public mental health Evidence based prescribing Clinical decision support Feedback systems
- American Psychiatric Association. (2006). Practice guidelines for the treatment of psychiatric disorders: Compendium 2006. Arlington: American Psychiatric Association.Google Scholar
- Cohen, T., Kaufman, D., White, T., Segal, G., Staub, A. B., Patel, V., et al. (2004). Cognitive evaluation of an innovative psychiatric clinical knowledge enhancement system. Medinfo, 11(2), 1295–1299.Google Scholar
- DeMakis, J. G., Beauchamp, C., Cull, W. L., Denwood, R., Eisen, S. A., Lofgren, R., et al. (2000). Improving residents’ compliance with standards of ambulatory care: Results from the VA cooperative study on computerized reminders. Journal of the American Medical Association, 284(11), 1411–1416.PubMedCrossRefGoogle Scholar
- Finnerty, M. (2009). Psyckes as a QI tool to decrease inpatient antipsychotic polypharmacy. In Proceedings of the 2009 Mental Health Services Research (MHSR) conference, Washington, DC. Retrieved from http://www.docstoc.com/docs/19978798/2009-Mental-Health-Services-Research-(MHSR).
- Kealy, E. (2009). Results—Psyckes: Sharing medicaid data to improve the quality of prescribing. In Proceedings of the 2009 Mental Health Services Research (MHSR) conference, Washington, DC. Retrieved from http://www.docstoc.com/docs/19978798/2009-Mental-Health-Services-Research-(MHSR).
- LaPointe, L., & Rivard, S. (2005). A multilevel model of resistance to information technology implementation. MIS Quarterly, 29(3), 461–491.Google Scholar
- Rijcken, C. A. W., Tobi, H., Vergouwen, C. M., & de Jong-van den Berg, L. T. W. (2004). Refill rate of antipsychotic drugs: An easy and inexpensive method to monitor patients’ compliance by using computerized pharmacy data. Pharmacoepidemiology and Drug Safety, 13, 365–370.PubMedCrossRefGoogle Scholar
- Texas Department of State Health Services (2007). Texas implementation of medical algorithms. Austin. Available at http://www.dshs.state.tx.us/mhprograms/TIMA.shtm.
- White, T., Finnerty, M., & Felton, C. (2004). Implementation of a novel, psychiatric clinical knowledge enhancement system to improve quality of care and reduce pharmacy expenditures. Medinfo (CD), 1906. Retrieved from http://cmbi.bjmu.edu.cn/news/report/2004/medinfo2004/pdffiles/papers/409_d040005601.pdf.