E-prescribing—The Good, The Bad and The Future.​

​Don’t even try to fight it. Since 2010, most healthcare systems in the world started plodding towards e-prescriptions as the standard format for doctors and dentists to transmit medicine dispensing information to pharmacists. Some countries jumped in early—Eastonia almost completely relying on e-prescribing in 2013—while others are still pounding out the legalities. The reasoning is simple: By requiring all prescriptions to be dispensed via a secure electronic system, lives will be saved and patient healthcare improved. As teledentistry increases in use, more patients will turn to the Internet to find online dental help and e-prescriptions expedites the healthcare process. It should be that easy. Unfortunately, reality is a bit more complicated.


Why are e-prescriptions considered safer than those little scribbled notes? Proponents point to the scribbles; misreading illegible writing has resulted in thousands of lives effected each year  by pharmaceutical errors. By providing clearly readable and properly documented orders, pharmacists can better deliver needed medicine to patients. No more dosing errors. No more ambiguous orders. Also, as e-prescriptions are sent directly to pharmacies, they are less likely to be lost or disregarded by patients. This means that more patients are more likely to follow their doctors’ orders.  


E-prescriptions are also credited with helping fight opioid abuse. An estimated 90 Americans die each day due to opioid overdose. Dentists prescribe roughly 12% of fast-acting pain relief prescriptions, making dental care providers particularly targeted by opioid abuse. A secure prescriber-to-dispenser system prevents forgery or alteration. An added bonus is that the FDA and the DEA can more easily track controlled substances. And when a drug recall is issued, electronic records make informing at-risk patients far easier than dealing with a paper-based prescription system. Of course, insurance providers can more readily verify drug claims.


And then there is the future. In 2001, the world marveled over the first true example of remote surgery. Now, drones are delivering emergency pharmaceutical supplies to otherwise inaccessible locations. Every day, rural areas and isolated communities are proving the value of telemedicine and teledentistry. As more and more people go online for dental diagnosis and care, a rise in e-prescribing must necessarily follow.


With all those positives, why is the practice of e-prescribing so scrutinized?


  1. Technology isn’t infallible. While e-prescribing looks easy, a busy physician or dentist can check the wrong drop-down item. A pharmacist can make a mistake entering data onto a label or transferring information into the pharmacy’s system. Human error will always happen.
  2. Data is at potential risk. No matter how big the company or how much security is woven into the fabric, personal information can be hacked and sold. Within days of Disney launching its streaming service, subscriber data was being sold on the dark web. Unlike entertainment service, e-prescribing involves extremely private and personal information. To compound the issue, many countries are working to intertwine prescription information to the complete electronic medical history of patients. And every step involved in the process is one more chink in the file’s security. 
  3. E-prescribing systems allow practitioners to let their assistants complete and send orders to pharmacies. A virtual dentist can perform an online dental examination, make a dental diagnosis then have his office manager send the online prescription. A manager—as invaluable as he or she is to a practice—is less likely to spot potential drug interactions or dosage issues. 
  4. Being an online and on demand dentist means that you need to save time. Yes, auto-fills help expedite writing a prescription, but this one simple high-tech time saver can mean that a prescription needs to be discarded and redone. It also can mean that a pharmacist gets two prescriptions—the discarded one as well as the redone version. Or it could mean that neither is sent. Auto-fills and auto-correct may not seem like a big issue, but this aspect of e-prescription systems is responsible for a significant number of errors. 


The world is evolving. Scientists on a remote island can have gum disease diagnosed online. A virtual dentist can provide online dental examinations then prescribe necessary medications by the simple stroke of the “enter” key. Then a drone can deliver the medication right to the patient’s home.


Yes, technology is amazing. Until it isn’t. A responsible teledentist must keep up with the flow of this high-tech environment. But what makes a professional truly a professional is his or her attention to getting details right. That includes developing methods to double-check e-prescriptions and confirming that your patient has received the medication. Consider implementing regular follow-up calls for patients on medication. Consider a weekly spot-check; randomly select a few patients from the schedule and compare their records to the e-prescriptions. Remain vigilant. Your patients deserve your best.