Study looks at most common eprescribing mistakes and how to prevent them


A recent study suggests that outpatient computer-generated prescriptions may be just as error-prone as your old paper versions. There is a solution to reduce mistakes, however. You can program your e-prescribing system to help you avoid common errors.

Research has found that eprescribing can be an important tool in preventing prescription errors. However, as with any technological tool, eprescribing is only as accurate as the prescriber who is using it, and processes must be in place to ensure meaningful system use.

A recent study published by JAMIA, the British Medical Journal Group’s health informatics journal, looked at the frequency, types, and causes of errors associated with outpatient eprescribing systems. The study’s goal was to classify the errors to determine preventive strategies.

The study found that nearly 12% of the computer-generated prescriptions-all of them from nonhospital physician offices-included at least one error, and more than one-third of those had potential for harm, according to the clinical panel reviewing them. That is not much different than paper systems, according to the researchers. Different eprescribing systems had varying error rates, from 5.1% to 37.5%.

The most common error was omitted information, which accounted for more than 60% of all mistakes.

The retrospective cohort study, funded by a grants from the Agency for Healthcare Research and Quality and the Harvard Risk Management Foundation, looked at 3,850 computer-generated prescriptions from three pharmacy chain outlets in Arizona, Florida, and Massachusetts over a four-week period in 2008.

The takeaway for primary care physicians is to make sure that your system is programmed with safeguards to help you avoid common errors, such as omitted dosages, incomplete drug names, or unclear instructions.

“Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors,” according to the researchers who, in addition to programming changes, also recommended systems with built-in dosage calculators to reduce mathematical errors.

Other studies have found that e-prescribing is very effective in reducing errors. Last year, researchers reported in the Journal of General Internal Medicine that electronic prescriptions can reduce prescribing errors up to 7-fold.

Go back to the current issue of eConsult.

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