Confirmation that electronic "signatures" will be allowed for Dunedin Hospital's national e-prescribing pilot, means the scheme should go ahead in two wards in September.
Southern District Health Board clinical leader of IT and acute internal medicine specialist, Dr Andrew Bowers, said the waiver allowing electronic signatures would apply only to the pilot.
It would, however, give the opportunity for safety data to be collected during the pilot to support future legislative change in this area.
Towards the end of the pilot there would also be opportunity to apply for a longer waiver until any legislative change occurred.
It had been hoped the $642,000 pilot being funded by the Ministry of Health's safe medication management programme would start this month, but delays in the signature approval affected that.
Dr Bowers said patients in acute internal medicine wards 8a and 8b, where the trial would take place, might not notice anything during the pilot.
That was the point.
Patients would not notice that their medications were correct, administered on time, did not cause unexpected harm through interactions with each other, and that discharge prescriptions were legible or complete.
They might notice that nurses administering medications at the bedside would be checking a computer to ensure they were giving the correct doses at the right time and to the right patient.
Behind the scenes, however, the situation would be "very different indeed".
There would be no paper charts for medications (although for a while intravenous regular fluids would be on a separate chart).
All medications would be recorded electronically from admission to discharge and could be accessed electronically at later admissions or outpatient clinics.
Requests for medications would be sent electronically to the hospital pharmacy, but not to community pharmacies.
There would be electronic decision-making support for the prescribing doctor, not only to check medicine interactions but to enable the choice of medicines preferred within the board medicine guidelines.
The prescribed medications would be legible, reducing errors of interpretation which applied to hand-writing.
Also the medication would not need to be manually transcribed on to discharge summaries and discharge prescriptions, something which was associated with about 6% of transcribing errors per prescription.
Dr Bowers considered the pilot was likely to be a "large step towards improved patient safety within our hospitals and beyond".
It might also benefit the community as a whole by reducing the associated financial costs of that harm.
Nationally, the Ministry of Health has estimated that hospital prescribing errors may cause 150 deaths a year and 4000 injuries nationally.
• Dunedin Hospital began an electronic prescribing pilot several years ago, without electronic signatures, but it faltered when it struck resistance from some staff who identified hardware and system difficulties.
In 2007 it had hoped to try again, this time with paperless prescribing and the use of electronic signatures. However, permission given then by the ministry for such signatures was later reconsidered.
