E-prescriptions could slash errors in hospitals

Intractable errors in traditional prescriptions could be dramatically reduced. Flickr/edwaado.

Electronic prescribing technology could reduce mistakes made by hospitals in medication prescriptions by up to 66%, a study has found.

The study of the technology in two hospitals found procedural errors such as incomplete, unclear medication orders fell by more than 90%. Serious errors, including the prescription of incorrect drugs or doses, fell by 44%.

The results of the study, by a team from the University of New South Wales, are published in the journal PLoS Medicine today.

Until now, there has been skepticism about the ability of the commercially available technology to address intractable errors in prescriptions. An e-health system to be introduced by the federal government in July has attracted criticism that it could increase risks for patients.

But the study leader, Professor Johanna Westbrook, from the University’s Australian Institute of Health Innovation, said the research provided solid support for the benefits of e-prescribing systems, which allow doctors to enter prescriptions into computer programs that usually show what other drugs a patient is using.

“Prescribing errors are one of the most significant patient safety issues internationally,” Professor Westbrook said. “We had a lot of hope about this technology, but before this study there hasn’t been much evidence.

"We found there was a reduction in serious errors of 44%, which is a very significant result. Procedural errors went down dramatically, as you’d expect when there’s no handwriting involved.”

Professor Westbrook cautioned that the US-developed technology introduced a new range of clinical errors, typically caused when doctors chose the wrong option from a drop-down menu.

“But when we looked at the new errors that were introduced, they were not nearly as severe as the sort that we previously encountered. They were relatively minor and could be addressed with better system monitoring.”

A 2006 report from the Institute of Medicine of the National Academics in America found that medication errors harm 1.5 million people in the United States every year. The resulting injuries cost at least $3.5 billion in extra medical costs to treat.

“There has been some resistance to this technology here because it’s very expensive to introduce, and it’s expensive to change the way doctors and nurses work,” Professor Westbrook said. “But in the long run, this research shows that it is worthwhile.”

Professor of Pharmacology Ric Day, who helped implement a commercial e-prescribing system at St Vincent’s Hospital, said that “from a clinician’s point of view this is an incredible result given the prevalence and the intractability of the problem.

"It’s even more significant given that we expect to see greater reductions once user support is added to the systems.”

“From a clinician’s point of view this is an incredible result given the prevalence and the intractability of the problem. It’s even more significant given that we expect to see greater reductions once user support is added to the systems.”

Staff at St Vincent’s were required to demonstrate they could use the computer system before they were allowed to prescribe or deliver any medications, he said.

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