Summary
ePRaSE is a web-based tool intended to help NHS hospital sites assess and evaluate their electronic prescribing (ePrescribing) systems to support optimisation and reduce harm caused by adverse medication prescribing events, ultimately improving patient safety.
The tool provides a set of 15 fictional 'patients', which users set up in their live or test ePrescribing environments, and then provides a set of 45 prescribing test scenarios to challenge their system responses to risk. There are also some additional direct configuration questions randomly spread through the scenarios to assess basic safety features in the build of the user's ePrescribing system. The performance of the ePrescribing system to both the risk scenarios and configuration questions is provided in real time with a text-based report and accompanying visuals. The report is intended to guide and assist ePrescribing system users and new implementers in the optimisation of their systems.
The latest version, ePRaSE 2024, is suitable for all sites actively using ePrescribing systems for adult patients, and is accessible to registered users with nhs.uk or nhs.net email accounts (up to four users per Trust). The report applies to the Trust as a whole.
The web-based ePRaSE application is compatible with all modern browsers: Google Chrome, Mozilla Firefox, Opera, Safari, and Edge.
If you would like to make ePRaSE part of your optimisation work, you can register at eprase.nhs.uk
Background
ePrescribing is the utilisation of electronic systems to facilitate and enhance the safety and efficacy of prescribing medicines to patients, and to provide a robust audit trail for the entire medicines use process. Implementation of ePrescribing with clinical decision support (CDS) has been extensively researched; many studies have shown reductions in medication error rates and preventable adverse effects. Following implementation of ePrescribing with CDS, medication errors tend to decrease over time as system configuration is optimised for local use and users adapt to the system. Greater patient safety benefits are documented with experienced users rather than new implementers. However, upgrades and system modifications can also introduce new safety risks, such as incompatibilities with legacy software. Detecting and managing safety risks can be difficult due to the complex nature of potential errors relating to not only the system itself, but also the behaviours of users and characteristics specific to organisations.
In the UK, there is currently no standard method of evaluating the effectiveness of ePrescribing systems in preventing medication errors or potential adverse drug events. NHS England, the UK Government organisation that oversees commissioning of NHS services in England, has commissioned the development of an Electronic Prescribing Risk and Safety Evaluation tool (ePRaSE) to evaluate the capabilities of the ePrescribing systems currently implemented in UK hospitals.