Article Text

Download PDFPDF
Opportunities and challenges in creating an international centralised knowledge base for clinical decision support systems in ePrescribing
  1. Kathrin M Cresswell1,
  2. David W Bates2,
  3. Shobha Phansalkar2,
  4. Aziz Sheikh1
  1. 1eHealth Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
  2. 2Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Aziz Sheikh, eHealth Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Doorway 3, Teviot Place, Edinburgh EH8 9AG, UK; aziz.sheikh{at}


Prescribing errors cause substantial potentially avoidable patient harm. There is increasing evidence that the implementation of clinical decision support systems to support prescribing may reduce the risk of such errors. Efforts have thus far concentrated on the implementation of these systems within local health communities. However, considerable potential benefit exists in sharing the content of these prescribing decision support systems across geographical boundaries, including the sharing of experiences and expertise and cost reduction, which could in turn potentially increase accessibility to low resource settings. Technical, commercial and regulatory issues would however first need to be overcome in order to facilitate such a development. In this paper, the authors reflect on some of the opportunities and challenges inherent in trying to develop an internationally agreed and shared computerised decision support system aiming to enhance prescribing safety.

  • Computerised physician order entry
  • electronic health records
  • medication safety
  • ePrescribing
  • decision-making
  • information technology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding DWB and SP were supported in part by grant number U18HS016970 from the Agency for Healthcare Research and Quality. AS and KMC have been supported by research grants from the NHS Connecting for Health Evaluation Programme (NHS CFHEP 001, 005, 009 and 010), the findings from which have informed the ideas contained in this paper.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.