WASHINGTON – Widespread use of electronic prescribing systems by all physicians is a key proposal in a national plan to significantly reduce medication errors proposed by an Institute of Medicine committee.

The report estimates that medication errors affect 1.5 million people and costs the nation at least $3.5 billion annually, not including expenses for lost wages and productivity.

Among its action steps for consumers, physicians, healthcare organizations and the government, the committee called for all prescriptions to be written electronically by 2010.

Other recommendations include: 

• Improving communication between healthcare professionals and patients.

• Encouraging patients to increase their involvement in their healthcare and take steps to protect themselves.
• Creating consumer-friendly information resources for drug information.

The cost of making the electronic prescribing process available to all physicians by 2010 would be high, and reimbursement for the technology could be an issue, said committee members at a press conference on Thursday.

However, initiatives in Massachusetts and Michigan are funded by insurers that expect savings from the investment in e-prescribing technology to reduce costs over the long run, said Albert W. Wu, MD, professor of health policy and management and internal medicine at Johns Hopkins University Baltimore.

While the cost of moving to widespread use of electronic prescribing could be significant for physicians, they need to view it as a needed investment that’s essential for doing business effectively and safely, said Wilson D. Pace, MD, professor of family medicine for the University of Colorado and the director of the National Research Network for the American Academy of Family Physicians.

“If an X-ray machine went out in a physician’s office, they wouldn’t think of not replacing it and doing without because it costs a lot of money,” he said. “In the same way, physicians have to look at electronic prescribing as a key tool in providing safe medical care.”

The report found that the use of paper-based prescribing is associated with high error rates. Electronic prescriptions preclude errors from bad handwriting and enables prescribers to use decision-support tools. However, significant regulatory issues and problems with automated alerts are still hurdles to be solved before widespread adoption occurs.

The committee also proposed that the Agency for Healthcare Research and Quality take the lead in fostering improvements in IT systems used in ordering, administering and monitoring drugs.

Medication administration in acute care settings is still a disjointed process that needs re-engineering, said J. Lyle Bootman, co-chair of the committee and dean and professor of the University of Arizona’s College of Pharmacy.

The IOM committee’s report is one offshoot of the 1998 report, “To Err is Human,” which highlighted the number of deaths and injuries in U.S. acute care facilities resulting from medical errors, he said.