title: The Challenges of Electronic Health Records and Diabetes Electronic Prescribing: Implications for Safety Net Care for Diverse Populations.
abstract: Widespread electronic health record (EHR) implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1) the adoption of RxNorm; (2) standardized naming and picklist options for high alert medications such as insulin; (3) the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4) enhanced bidirectional communication with pharmacy partners; and (5) informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, UCSF Center for Vulnerable Populations, University of California, San Francisco, 1001 Potrero Avenue, Box 1364, San Francisco, CA 94143, USA.
authors.forename: Neda
authors.identifier: 0000-0001-9944-6923
authors.initials: N
authors.lastname: Ratanawongsa
authors.affiliation: San Francisco Department of Public Health, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
authors.forename: Lenny L S
authors.initials: LL
authors.lastname: Chan
authors.affiliation: Laguna Honda Hospital and Rehabilitation Center, 375 Laguna Honda Blvd, San Francisco, CA 94116, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Fouts
authors.affiliation: Division of Endocrinology, Department of Medicine, University of California, San Francisco, 1001 Potrero Avenue, Box 0862, San Francisco, CA 94143, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Murphy
mesh_terms: D003920:Diabetes Mellitus / Q000188:drug therapy*; D057286:Electronic Health Records; D055695:Electronic Prescribing; D006801:Humans; D061214:Patient Safety