Electronic Prescriptions May Not Reduce Prescription Errors
Bloomgberg.com reported recently that up to 12% of prescriptions sent electronically to pharmacies have some kind of doctor medication mistake. This is the same as the percentage of errors found in handwritten prescriptions.
3,850 electronic prescriptions written over a four week period were examined. The study published in the Journal of the American Medical Informatics Association shows 452 of these contained errors, 163 of which could have harmed the patient. The most common error was the omission of information related to dose or how often to take the medication.
The U.S. Government has paid over $158.3 million to doctors and hospitals to help facilitate the use of electronic medical record systems. The computer systems are meant to reduce errors thereby lowering healthcare costs. This study shows that the electronic systems need fail safes to prevent doctor medication errors as touted.
The CPOE System Increases Duplicate Orders
Informationweek.com reported recently on a study in the Journal of the American Medical Infometrics Association that shows electronic systems that are meant to reduce hospital medication errors might have the opposite effect. Computerized physician order entry (CPOE) systems are paired with clinical decision support (CDS) systems because they were meant to decrease the chance of duplicated orders and medical errors. The study shows that the opposite is true and in fact the use of these electronic systems increase the chance of duplicated orders in hospitals.
In examining different hospital intensive care units, researchers found that systems in place to prevent patients from receiving too much medicine are ineffective. Errors uncovered included identical drugs being ordered by multiple providers, repeat medication orders being placed at shift changes, and a system that failed to recognize true duplicates while flagging legitimate orders. The computer did not recognize oral forms and intravenous forms of a medication as being the same drug.
Comparing data from before and after the implementation of the CPOE system showed the duplication rate tripled from 0.36 percent to 1.72 percent and the same medication errors increased from 0.31 percent to 1.87 percent. Both of these errors can lead to a medicine overdose which can have serious consequences.
The study concluded that solutions to drug errors in hospitals must be multifaceted and providers cannot rely solely on computers to catch mistakes. Suggested solutions included better communication between doctors and nurses, particularly at shift changes, improved computer systems that would better recognize duplicate drugs, and optimized care protocols to protect patients against drug overdose. With computer systems leading to a 600% increase in mistakes, clearly they cannot be the only answer.
Doctors need to double check their prescriptions whether sending them electronically or writing them by hand to prevent medication errors. Pharmacists should take the time to verify confusing or missing information before dispensing the wrong medicine. This is the best way to reduce the number of medication mistakes and therefore healthcare costs.