I use National eRx for most of my prescribing, and although I like it, the user interface is really clumsy to use and could be vastly improved to speed things up. It’s free, and that counts for something.

I’ll write a review of National eRx some other time, but I just want to rant a bit about how unbelievably clumsy the current system for e-prescribing here in Maryland tends to be.

As far as I can tell, almost no pharmacies actually accept prescriptions from National eRx directly. Instead, every pharmacist I’ve spoken to about it describes a long and clumsy process of either receiving faxed prescriptions with some unknown delay from minutes to days or only getting the prescriptions halfway into whatever proprietary system the pharmacy uses but not having any real integration–there’s still a lot of manual data entry, and someone has to remember to check the queue in many cases.

End result: wasted time for patients, pharmacists and me.

I can’t understand what would be wrong with having one national database for the whole country which doctors and pharmacists could log onto and leave and fill orders for prescriptions.

I think many banks routinely handle many more transactions per minute that would be necessary to do all prescriptions electronically, so it really isn’t a technological issue at all, as far as I can see.

There’s a lot of talk these days about initiatives and grants to improve healthcare.

Why not start with putting together a federated database of prescriptions? Every doctor I know, whether psychiatrist or not, would benefit from a simple web-based interface to write prescriptions and pharmacies could just take off all the prescriptions electronically. If the database was federated, it would make sense for pharmacies to integrate that database with their own proprietary systems.

I realise there’s lot of issues here: privacy, security, load-balancing, and the like, but it seems to me that banks are pretty much already there so far as I can see.

Forget all these attempts to do complicated electronic medical records and so forth right now. Get a national drug list that every physician in every ER in the country could have access to. It would save a lot of medication and physician errors, and cut down on illegal diversion of controlled substances besides.