Cedric Meyerowitz wrote:
You wtote: Drug interaction databases need to be not dangerous (example a
patient
being allergic to Bactrim but the doctor can happily prescribe Trimethoprim)
The problem is not with the software developer but with the Doctor using the
software. When there was a big uptake of IT by GP's a few years ago, when
HIC offered all this money for IT uptake, there were lots of articles
published about GP's printing scrripts with default settings of the program
- ie. Take 1-2 tablets when eyedrops were prescribed etc. I still regularly
see scripts generated elsewhere, where the Doctor hasn't bothered to set up
the margins. I still regularly get new patients and there health summary
contains the same diagnoses twice, the same drugs are prescibed twice
(example Losec 1 nocte, Probitor 1 nocte) - only because the Doctors don't
know how to use there software, or they can't be bothered.
When it comes to allergies: Bactrim allergy implies allergy to Bactrim.
That implies save to give Trimethoprim. If the allergy was to Trimethoprim,
the Doctor should enter the allergy as Trimethoprim. We all have patients
that are sensitive to Valium, but they can safely take Ducene. Thus there
is a difference in how one enters a allergy. I still have female patients
that claim Triphasil didn't agree with them, but Triquilar is 100% okay -
yet is exactly the same drug. Amoxil allergy again does not imply a
Penicillin allergy.
Cedric
Cedric,
My take on this problem is that the funding to Divisions for training
their members cut out way too soon, and the powers that be thought that
if a GP had a PC on their desk, they could do anything and everything
the powers imagined with it. Some Divisions are still running training
programs, and yes what you describe is still, unfortunately, not uncommon.
Another variant is having everything ever prescribed in the current
medication list because everything is selected as 'regular'. This annoys
specialists, of course, who discover that the patient isn't on most of
the stuff in the referral letter. Only a few months ago one GP asked why
some of the listed medications for a particular patient were in red.
I think what you are saying is that we need to certify the doctor's
capacity for using their clinical software as well as the software
itself. Mr Abbott quoted a study late last year that obviously made him
aware that everything isn't rosy in this particular garden, but to date
there's been no action other than some changes in the PIP incentives,
which were long overdue anyway.
Enough GPs I know have developed good skills, are conscientious, and
make their software work for them and their patients, for me to feel
that efforts to continue offering training are worthwhile.
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
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