Computerized ambulatory-care pharmacy information system for direct order entry by prescribers

A computer system that links prescribers in a diabetes center to an ambulatory-care satellite pharmacy is described. In 1988 an ambulatory-care center serving the diabetic patients of a 437-bed university teaching hospital moved to a new location. To maintain efficient communication of prescription information from the diabetes center to a designated ambulatory-care satellite pharmacy, a program that enables diabetes center prescribers to enter their orders directly into the satellite pharmacy computer system was implemented. The pharmacy department's prescription-entry screen was reprogrammed so that it could be more easily used by prescribers, and a "default" list of the most frequently prescribed drugs was generated to simplify direct order entry. Prescription information entered at the diabetes center is transmitted to the satellite pharmacy; the filled prescriptions are usually ready by the time patients arrive. The average number of prescriptions entered into the computer per week remained steady during the first 14 weeks that the system was in use but increased substantially after diabetes center personnel were given a summary of use data and other information pertaining to the new system. However, because of the availability of only one terminal for order entry and the inherent ease and speed of writing prescriptions on paper, use of the system has not met expectations despite the benefits it offers. Prescribers in a diabetes center did not frequently enter prescription information into a computer system linked to the hospital's ambulatory-care pharmacy because the traditional method of writing prescriptions remained available and convenient.