My adverse reaction to prescribing software

6minutes loves computers and gadgets, but has long complained about her medical software – a minor player in the market – especially in regards to the lack of drug alert prioritisation. Most infuriating are alerts which tell me the two drugs in a compound preparation interact with each other.
My previous grumbles have attracted silence on the part of the software company, (admittedly not named in previous rants) and an “it’s our database but it’s up to the software companies how they use it”, reply from MIMS, the drug database used by my software, Plexus, owned by IBA.
A recent discussion with an insider in the medical software industry shed light on why the quality of clinical software tends to lag behind that of billing packages.
As is the case for most products, there are two main drivers for companies to produce high quality software – a healthy financial return and regulatory requirements.
On the financial side, software manufacturers want doctors to buy their brand, and therefore aim to produce a competitive product. Unfortunately, market forces are yet to push the calibre of clinical software to dizzying heights.
The other source of funds for software companies are government subsidies, but these are project based and serve the government’s purpose of collecting data, saving money, and winning votes through things like simpler billing – think HIC online, HealthConnect and MediConnect. As 6minutes understands it, there are no subsidies for global functionality, ie safe, user-friendly programs with quality decision-support.
Perversely, software company’s own insurance policies don’t encourage quality either. A program doesn’t need to have an easily accessible allergy field but does require every potential drug interaction to be included, regardless of how trivial and confusing for the prescriber.
On the regulatory front, industry standards and government requirements appear to have little impact despite ample data that electronic prescribing is causing harm as well as benefit.
Clinical software simply needs to improve.
Patients, doctors and taxpayers deserve software that facilitates safe and wise prescribing, including features such as prioritised drug alerts, better drug-disease information, and a compulsory dashboard of basic information, including allergies.
Government has little hesitation in forcing doctors to jump through hoops in the name of quality and safety.
It’s time it demanded the same of medical software companies.