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E-prescribing is Not Error Free


Outpatient electronic prescribing systems don't cut out common mistakes.

This article published with permission from The Burrill Report.

Many medication errors are attributed to doctors’ illegible handwriting, but a new study suggests that outpatient electronic prescribing systems also contain many of the same common mistakes in manual systems.

The rapid adoption of electronic prescribing systems has in part been fueled by the belief that they would reduce the sorts of errors commonly made in manual prescribing systems, according to the authors of research published online in the Journal of the American Medical Informatics Association.

The study analyzed 3,850 computer-generated prescriptions received by a commercial pharmacy chain in three different states over a period of four weeks in 2008.

The authors looked at the number of mistakes made and their potential to cause harm, as well as the frequency of particular mistakes and whether these were associated with one type of system. They found that almost 12% of prescriptions in the systems contained errors, a third of which were deemed to be potentially harmful.

Mistakes were classified within three categories: significant errors posing little serious threat to life, such as rash, headache or diarrhea; errors that were serious but not life threatening, resulting in problems such as low blood sugar, reduced heart rate and fainting; and errors responsible for issues that were life threatening if not treated, such as heart attack and respiratory failure.

Among the 163 potentially harmful errors, more than half, 58%, were significant and the remainder was serious.

Four out of 10 medication errors involved anti-inflammatory drugs and antibiotics, and the most common types of drugs associated with errors were nervous system drugs (27%), cardiovascular drugs (13.5%), and anti-inflammatories/antibiotics (12.3%).

For example, in system A, omitting to specify length of treatment and dose were common, and “miscellaneous” errors accounted for more than one in four mistakes. And while system B’s error rate was less than that of system G, system B incurred substantially more potentially harmful errors.

Almost two-thirds of errors related to missing information, which the authors suggest should be relatively easy to eliminate by some judicious tweaking or providing better training for the users.

Not all e-prescribing systems are the same — some performed worse than others. Prescribing errors ranged from 5% to 37% among the 13 systems that were used, with the frequency of certain types of errors associated with particular systems.Copyright 2011 Burrill & Company. For more life sciences news and information, visit www.burrillreport.com.

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