Time to Rethink the Use of Free-Text Notes in E-Prescriptions?

April 6, 2016 | Strategic Insights for Health System


​Two-thirds of optional free-text notes in ambulatory electronic prescriptions contain inappropriate information, and another 5% contain irrelevant information, according to a study published in the April 2016 edition of JAMA Internal Medicine. The authors performed a qualitative analysis on 26,341 randomly selected e-prescriptions that contained free-text notes transmitted to a community pharmacy during a one-week period in 2013 and found that 17,421 (66.1%) contained inappropriate information. Inappropriate information was defined as "content for which a standard, structured data-entry field is available in the widely implemented national e-prescribing standard." Further characterization of the inappropriate content found that 19% contained conflicting directions. Meanwhile, nearly half of the 7,785 of e-prescriptions classified as having appropriate content in the free-text notes contained information that could be communicated through standard fields (3,685, 47.3%).

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