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Adverse Drug Events And Health Smart Cards

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ADRs and smart health

cards

The commentary by Paula Rochon and colleagues1highlights the importance

of information technology in drug safety. In recent years medication er-ror has received considerable atten-tion, because it causes substantial mortality and morbidity and leads to additional health care costs. This source of preventable harm to hospital patients represents an area where in-formation technology will have a posi-tive impact.

The use of computerized physician order entry and online alerts to reduce medication errors are common ele-ments of medication safety policy. We have implemented an automated alert system for drug–drug interactions in Taipei Municipal Wanfang Hospital (which is managed by Taipei Medical University). This system alerts the clini-cian in real time if a drug–drug interac-tion is detected for prescripinterac-tions given at our hospital. However, it is common for patients to be taking drugs from different hospitals or clinics at the same time. Now, our system is able to detect drug–drug interactions for pre-scriptions from different hospitals by checking the electronic prescription records on the patient’s National Health Insurance (NHI) integrated cir-cuit (IC) card. These cards have been in use since July 2003 and have fully re-placed paper cards since January 2004. Hospitals must be able to use and sup-port the IC cards to provide medical services for insured patients.

Four types of information are stored on the NHI IC card: personal informa-tion, NHI-related informainforma-tion, medical service information (e.g., drug aller-gies, long-term care prescriptions, am-bulatory care prescriptions, and certain medical treatments) and public health information (including personal im-munization records and willingness to donate organs). The electronic pre-scription records on the NHI IC card are a valuable way to detect drug–drug interactions between prescriptions from different hospitals.

Min-Huei Hsu Yu-Chuan Li Chien-Tsai Liu

Graduate Institute of Medical Informatics

Taipei Medical University Taipei, Taiwan

REFERENCE

1. Rochon PA, Field TS, Bates DW, et al. Clinical ap-plication of a computerized system for physician order entry with clinical decision support to pre-vent adverse drug epre-vents in long-term care [edito-rial]. CMAJ 2006;174(1):52-4.

DOI:10.1503/cmaj.1060032

«Oui» à l’indépendance

éditoriale, «non» à

l’ingérence politique

L’autonomie éditoriale est garante de la liberté d’expression et de l’intégrité

d’une revue scientifique, dont la répu-tation et la crédibilité dépendent en grande partie de l’adhésion à ce principe. En congédiant sans motif valable une équipe éditoriale de renommée mondiale, le JAMC agit non seulement contre l’intérêt public, mais nuit à sa propre réputation. En effet, une fois que l’intégrité scien-tifique d’une revue est teintée par des intérêts politiques, elle perd toute crédibilité. Il devient très difficile de persuader des chercheurs de grand renom de publier des articles dans une revue dont la réputation a été entachée par la transgression de l’autonomie éditoriale. Les visées d’une revue scientifique de haut calibre sont in-conciliables avec celles d’un véhicule d’opinion au service des membres d’une association médicale.

Nous croyons que seule l’indépen-dance éditoriale peut garantir aux médecins et aux autres professionnels de la santé, aux chercheurs et à la so-ciété en général, que le JAMC de-meure une source rigoureuse et im-partiale d’information scientifique sur la santé. L’AMC ne devrait pas cen-surer l’information à des fins poli-tiques, stratégiques ou corporatives, mais au contraire, protéger la liberté et l’indépendance éditoriales du JAMC.

Toutes les revues scientifiques sérieuses — comme les médias d’ailleurs — sont appelées un jour ou l’autre à publier des articles pouvant di-verger des intérêts idéologiques ou commerciaux de leurs propriétaires.

Letters

CMAJ • August 15, 2006 • 175(4) | 385

© 2006 CMA Media Inc. or its licensors

Letters submission process

CMAJ’s enhanced letters feature is now the portal for all submissions to our

letters column. To prepare a letter, visit www.cmaj.ca and click “Submit a response to this article” in the box near the top right-hand corner of any CMAJ article. All letters will be considered for publication in the print journal. Letters written in response to an article published in CMAJ are more likely to be accepted for print publication if they are submitted within 2 months of the article’s publication date. Letters accepted for print publication are edited for length (usually 250 words) and house style.

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