Print“Providers appear to be rapidly adopting electronic health records and computerized prescribing, and one of the major anticipated benefits is expected to be through medication-error reduction.”
Many medication errors are attributed to doctors’ illegible handwriting, but a new study suggests that outpatient electronic prescribing systems also contain many of the common mistakes of manual systems. The rapid adoption of electronic prescribing systems has in part been fuelled by the belief that they would reduce the sorts of errors commonly made in manual prescribing systems, say 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 percent 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, or 58 percent, were significant and the remainder was serious.
Four out of ten medication errors involved anti-inflammatory drugs and antibiotics, and the most common types of drugs associated with errors were nervous system drugs (27 percent), cardiovascular drugs (13.5 percent), and anti-inflammatories/antibiotics (12.3 percent).
Not all e-prescribing systems are the same with some performing worse than others. Prescribing errors ranged from 5 percent to 37 percent among the 13 systems that were used, with the frequency of certain types of errors associated with particular systems.
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.
July 08, 2011
http://www.burrillreport.com/article-e_prescribing_is_not_error_free.html
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