Handwritten to Electronic Prescriptions: Emerging Views and Practices, Saudi Arabia

Background: There has been little research on electronic prescribing (EP) in Middle Eastern countries. This is in part due to the slow implementation of electronic health records [EHR] integrated with EP. Electronic prescribing is associated with a considerable reduction in medication errors compared to handwritten prescriptions.
Objective: This paper reviews the relevant literature on handwritten and EP in the Kingdom of Saudi Arabia, as well as focusing on global issues including problems related to handwritten prescribing, the role of EP in mitigating these problems, the functions of the EHR system with EP, ways of implementing EP, and identifying potential barriers and challenges in the Middle Eastern region.
Search Strategy: Computer searches of PubMed and Google Scholar were conducted using the keywords “handwritten prescription,” “pen and pencil prescription,” “medication prescribing,” “medication errors,” “electronic prescribing,” and “electronic medical records.” These keywords were combined with ‘mechanisms’, ‘standards’, ‘advantages’, ‘disadvantages’, ‘challenges’, ‘plan’, and ‘opportunities’ with the objective of comprehensively retrieving the peer-reviewed articles published in English language journals on this subject. A total of 101 studies were included in this work. Methods: Two of the authors of this work retrieved and reviewed 101 papers that met our inclusion criteria. Any disagreements were resolved by a consensus of all three authors.
Results: There were more articles on handwritten prescriptions that involved illegible writing that resulted in medication errors than articles on EP due to a lack of research and slow implementation of EHR system in the Middle East. At global level, e-prescribing that was supported by well-defined standards and careful implementation was associated with a reduction in serious medication errors, morbidity, mortality, and service cost, as well as an increase in work flow efficiency, a higher quality of healthcare service delivery, and greater satisfaction of both healthcare providers and consumers. Electronic prescribing is now being practiced in many major medical centers and specialist hospitals not only in KSA but also in other countries of the region. However, there remains a need to implement EP systems in hospitals, primary care outpatient settings, and throughout the private health sector where it is missing.
Conclusion: It is time for the widespread adoption of EP, EHR, and health informatics systems across Middle Eastern countries including KSA, as well as for systematic research to evaluate their effectiveness.