US Pharm. 2008;33(2):2.

For many seasoned pharmacists, the days of typing prescription labels on a typewriter, filling out patient profiles by hand, submitting paper insurance claims, and handling many other manual administrative chores are distant memories. For more recently graduated pharmacists, the high-tech world of pharmacy is the only work environment they know. I don't think there is a pharmacist working today who can honestly say that technology hasn't changed the way pharmacy is being practiced. And while today's pharmacists enjoy the ease with which they can type a prescription label, check drug interactions, update a patient's medical history, submit insurance claim forms, and robotically fill prescriptions, they should never lose sight of the fact that the computer chip that runs all their high-tech equipment is only as good as the information fed into it.

Several decades ago, many pharmacy pundits predicted that emerging technology would replace the pharmacist, but obviously that has not happened. A computer has no compassion and cannot perform e-ffective professional customer services like face-to-face consultations or making sure patients are complying with and adhering to their medication therapy. Oh sure, a computer can be programmed to generate impersonal reminder messages about refills and key drug information, but it can't offer comfort to a sick patient who needs consoling or talk to confused patients who may need a little extra help with taking their medications.

There is much discussion lately about how e-prescribing is the answer to all of pharmacy's woes, particularly drug errors. In fact, a spokesperson for General Motors was quoted in the Detroit News as saying, "The benefits of ePrescribing are overwhelming in terms of reducing medication errors." I'm not so sure. There is little doubt that e-prescribing will certainly all but eliminate prescription errors caused by sloppy physician handwriting, but it does nothing for prescriptions that are written incorrectly in the first place, and that seems to be a far bigger issue than illegible handwriting. One New York pharmacist recently wrote me that she has personally witnessed several errors with prescriptions that were electronically transmitted. She recalled one instance in which a very legible electronically transmitted prescription had the wrong drug prescribed on it. The pharmacist caught the mistake because the prescription was not consistent with her patient's medical and drug history. Other problems she's encountered are prescriptions containing "strengths which do not exist, directions which are terminated before the prescription was sent electronically [she thinks the directions may have been too long and didn't entirely fit into that data field], and no indication of whether the physician prescribed a generic or brand." She has also received prescriptions for patients who normally do not get their prescriptions filled in her store. She said that several times patients have arrived to pick up an electronically transmitted prescription that was not yet transmitted. In such cases, she must then call the doctor and get the prescription over the phone. The electronic prescription generally arrives after the patient has already left the store with the filled prescription in hand. That wouldn't be so bad if it weren't for the fact that she is paying a transmission fee for every e -prescription she receives. She concludes: "I haven't found electronic transmissions to have decreased mistakes or saved time; it just changed the nature of mistakes being committed and causes me to call the physician for a different reason. Adding insult to injury, my pharmacy is paying for these mistakes to be transmitted."

I understand that this example is one pharmacy in one city, but it makes me wonder how many times this situation is occurring in pharmacies across the country. There is no question that technology has its place in pharmacy, but make no mistake about one thing: It is still no substitute for the e-ffective pharmacist.

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