Electronic Prescription Error Rates

The Clinical Advisor published an article this month concerning a 2008 study of electronic prescription error rates that, if still true, should give industry officials some cause for concern. According to the study, “The analysis focused on 3,850 computer-generated prescriptions received across three states over four weeks in 2008. In total, 452 prescriptions (11.7%) contained 466 errors, 163 (35%) of which were considered potential adverse drug events. None of the errors were life-threatening. Omitted information was the most common mistake, accounting for 60.7% of all errors.
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While the article is interesting, its efficacy is limited by its date-it’s already three years old and technology has made significant advances since that time. (I would be very interested to see if a more recent study came to the same conclusions.) Secondly, if the overwhelming majority of errors concern errors of omission, there’s a reasonably easy solution-implement prescription writing software that doesn’t allow for such omissions ie. the one entering the data can not proceed until the error of omission is corrected.
Perhaps the most significant statement in the article is this: “Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors,” cautioned Karen C. Nanji, MD, and coauthors in their report for Journal of the American Medical Informatics Association.

Holly Haines