Put down the pen: Rx errors drop by about 60% with e-prescribing systems

Computer entry cut incomplete, unclear orders

One way to prevent medication errors: Commercial e-prescribing systems, according to a new study in PLoS Medicine.

For the study, researchers from the University of New South Wales examined medication errors that occurred before and after the implementation of e-prescribing systems at two teaching hospitals in Sydney, Australia. They examined 3,291 patient records for medication mistakes such as clinical errors, incomplete or unclear drug orders, and incorrect drug or dosing.

The study found that medication error rates declined by between 58% and 66% in three hospital units that adopted e-prescribing systems, compared with units that did not implement the systems.

Researchers said the study shows that e-prescribing leads to a "statistically significant reduction in total prescribing error rates by more than 55%, driven by the substantial reductions in incomplete, illegal, and unclear orders."

  • The Advisory Board's IT experts put e-prescribing errors in context and suggest how hospitals can best implement the systems.

However, the researchers noted that e-prescribing systems sometimes can contribute to medication mistakes.

Johanna Westbrook—lead author of the study and director of the Centre for Health Systems and Safety Research at the University of New South Wales—said that about 35% of the medication errors that occurred after the installation of the e-prescribing systems were related to software design.

Westbrook noted that electronic systems can lead to errors "that would never occur on paper," such as selecting the wrong option from a drop-down menu (Ullman, MedPage Today, 1/31; Burnham, "Shots," NPR, 1/31; Lohman, Computerworld Australia, 2/1).

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