Computerized prescribing: building the electronic infrastructure for better medication usage

JAMA. 1998 Apr 1;279(13):1024-9. doi: 10.1001/jama.279.13.1024.


Computerized prescribing in the practice of medicine is a change that is overdue. Virtually all prescriptions in the United States are still handwritten. Instead, medications should be ordered on a computer interacting with 3 databases: patient drug history, scientific drug information and guideline reference, and patient-specific (weight, laboratory) data. Current problems with prescribing on which computerized prescribing could have a positive impact include (1) drug selection; (2) patient role in pharmacotherapy risk-benefit decision making; (3) screening for interactions (drug-drug, drug-laboratory, drug-disease); (4) linkages between laboratory and pharmacy; (5) dosing calculations and scheduling; (6) coordination between team members, particularly concerning patient education; (7) monitoring and documenting adverse effects; and (8) postmarketing surveillance of therapy outcomes. Computerized prescribing is an important component of clinician order entry. Development of this tool has been impeded by a number of conceptual, implementation, and policy barriers. Overcoming these constraints will require clinically and professionally guided vision and leadership.

MeSH terms

  • Clinical Laboratory Information Systems
  • Clinical Pharmacy Information Systems*
  • Computer Systems
  • Databases, Factual
  • Drug Information Services
  • Drug Prescriptions*
  • Drug-Related Side Effects and Adverse Reactions
  • Humans
  • Interdepartmental Relations
  • Medical Records Systems, Computerized
  • Software
  • United States