The Key to Solving Medication Errors is At The Intersection of Technology and Standards

1.5 million people are affected by medication errors each year, posing a significant risk to patients’ safety and increasing healthcare costs. While providers do everything in their power to prevent medication errors, interoperability and lack of visibility into a patient’s medication history can cause serious challenges.

Prescribing medication is a multi-step process and mistakes can be made at any point during prescribing, dispensing, or administering drugs. Human error, such as miscommunication, data entry mistakes, or misinterpretation of prescriptions, is one of the biggest culprits, but with advances in technology, those types of errors can be greatly reduced. In fact, 20% of adverse drug events (ADEs) that have been associated with medication errors are defined as “preventable”.

In recent years, NCPDP has been focused on adopting standards that enhance medication safety, streamline workflows, and support healthcare professionals. 

By integrating industry standards into e-prescribing software, prescribing organizations can reduce errors to improve patient outcomes and lessen the burden of medication-related errors on healthcare systems.

Here’s a look at the new National Council for Prescription Drug Programs (NCPDP) Sig Standard aimed at improving prescription accuracy. 

What is the NCPDP Sig Builder? 

When prescribing organizations adapt the NCPDP Sig Builder into their workflow, providers can digitize an otherwise manual process. The new standard translates previously free-text instructions (e.g., “Take 1 tablet by mouth twice daily”) into codified elements like dose, route, and frequency to ensure interoperability across healthcare IT systems and eliminate the need for a back-and-forth with the pharmacy. You can think of it as a template to ensure accuracy and consistency with standard ePrescribing elements.

What are some common elements that are included in a Structured Sig? 

• The action(s) a patient needs to take with the medication, such as take, give, apply, etc.
• The dosage or form of the medication including number of tablets, puffs, injections, etc. 
• How the medication should be taken – for example by mouth (PO), subcutaneous
• How often a patient should take the medication (BID = twice daily, q4h = every 4 hours)
• Length of time that an individual should take the prescribed medication. Instructions can include a start and stop date or length of time.
• Includes additional instructions such as “with meals” or “as needed”

What is the impact of the new NCPDP Sig Builder?  

While the adoption of the NCPDP Sig Builder is relatively new, the overall benefit is the advancement of the interoperability that ensures consistent information is exchanged from the provider to the pharmacy. Of utmost importance, the new standard reduces ambiguity, lowers risk and ensures patient safety when prescribing new medications. It also shortens the delay and reduces the back and forth when a sig is not correct between the prescriber and the pharmacy. It is also a time saver for providers as they have templated options and reduces the amount of free text fields. 

With the introduction of the NCPDP SIG Builder into e-prescribing software, prescribers are taking steps to ensure consistent interoperability and improve prescription accuracy. Most importantly, prescribers are eliminating ambiguity and improving patient safety. The wider ramification of the codified sig also accelerates advancements in utilizing AI to more accurately detect errors and proactively prevent these errors at a higher rate. With smarter, safer, and more efficient medication delivery, there will be better patient outcomes as well as reduced costs and complications on an already complex and overburdened healthcare system.

Photo: Ivan-balvan, Getty Images

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