Five years after its introduction at a state mental hospital, an
automated drug exception review system continues to show a long-term impact
on the prescribing practices of hospital physicians. Although the overall
rate of exceptions has remained low, approximately 25% of all new
exceptions pointed out by the computer result in a change in the order by
the physician. The fact that 60% of new exceptions are justified suggests
that some forms of polypharmacy may be appropriate. The integration of the
exception-reporting system into the clinical review process has avoided the
danger of the computer's being seen as an adversary to the clinician or as
exerting undue control over psychopharmacologic prescription practices.Abstract Teaser