Dr. Craig Morrow demonstrates software that allows him to issue prescriptions electronically. Morrow predicts that paper prescriptions will be a thing of the past in five years. Photo by Clint Karlsen.

At least one person died in Nevada last year because of a medication error, and 27 complaints went before the state's Pharmacy Board.

That's one death and 27 complaints too many, health officials say.

In an effort to reduce the medication errors in the state, Sierra Health Services has partnered with Allscripts, a provider of clinical software, to provide each licensed physician in Nevada access to electronic prescribing. Sierra Health Services is the state's largest provider of health services, including insurance.

Under the initiative, physicians who are members of the Nevada State Medical Association can receive Allscripts' software at no cost for two years.

Physicians who are not members of the association are eligible for the software at no cost but will have to pay a $20 monthly fee to use it. All physicians are responsible for their own hardware or computers and monitors.

With electronic prescribing, also known as e-prescribing, physicians use computers or other handheld devices to generate prescriptions and send them to pharmacies by way of a secured wireless network.

Experts say e-prescribing reduces the risk of medical errors by eliminating the physicians' often hard-to-read handwriting and by automatically searching drug interactions, allergies and duplication of medications.

According to the federal Food and Drug Administration, medication errors in the U.S. cause at least one death every day and injure approximately 1.3 million people a year. Medication errors can occur anywhere within the distribution system and are usually the result of poor communication.

Jeri Walter, a coordinator of services at the Nevada State Board of Pharmacy, said 27 hearings were held last year based on complaints by people who had been harmed because their prescriptions either were misfilled, caused an allergic reaction, or weren't properly explained to them.

Walter, who receives medication error complaints and assigns investigators to them, said 14 complaints received this year are set for hearings in upcoming months. The one involving the death is also scheduled for this year, though she wouldn't go into details about it.

"Not all complaints make it to hearing though,'' she said.

"Regrettably, medical errors happen, and everyone is trying to reduce those errors,'' said Dr. Craig Morrow, an internal medicine physician for Southwest Medical Associates, a subsidiary of Sierra Health Services. Morrow said at least 200 of the 250 physicians associated with Southwest Medical are e-prescribing.

As a whole, Southwest Medical Associates is producing about 1 million e-prescriptions a year.

The initial partnership between Sierra Health Services and Allscripts began in December.

So far, only about 50 physicians outside Southwest Medical Associates have come aboard.

Dr. John Ellerton, a Las Vegas oncologist, is one of them.

The biggest advantage in e-prescribing is the record- keeping aspect, he said.

"You can be in the patient's room and send the prescription. That's nice, and from a record-keeping standpoint, it's really nice,'' said Ellerton who uses a hand-held system.

Ellerton said pharmacies associated with Allscripts can send a message to physicians asking about renewals instead of the traditional phone call or fax.

"So, you have this inquiry that is in your database,'' he said. "That's kind of slick because physicians get a lot of requests for renewals.''

Despite the advantages of e-prescribing, Ellerton said there are some issues that need to be resolved.

For one, the method depends on reliable Internet connectivity and the physician not having computer problems. Should there be a problem with the physician's or pharmacist's computer, the prescription won't get sent.

Another fundamental problem is cost, he said.

"We have heard from the president that he wants to have electronic prescribing and medical records implemented throughout the country. There are some talks of mandating and penalizing people who don't use it eventually. My question is, how is the average physician going to afford to do this? This is extremely expensive, and that's a serious problem,'' he said.

"I can tell you, although the Allscripts' product was free, I spent a lot of money upgrading several computers -- and I'm fairly computer savvy. But the average physician will need assistance. That's another cost.

"Realistically, any intent to help the average physician implement this should come through either subsidies or a tax break.''

Despite limited interest in e-prescribing outside Southwest Medical, Morrow believes it's a matter of time before paper prescriptions are obsolete in Nevada.

"I expect in the next five years that most, if not all, physicians here will have done away with writing prescriptions on paper,'' he said. "This is so much safer and convenient for both physician and the patient."