Electronic Prescription Systems Greatly Reduce Errors

Researchers at Weill Cornell Medical College (New York, NY, USA) examined prescriptions written by health care providers at 12 community practices in the Hudson Valley region (NY, USA) from September 2005 through June 2007. They then compared the number and severity of prescription errors between 15 health care providers who had adopted e-prescribing practices, and 15 others who continued to write prescriptions by hand. The providers who adopted e prescribing used a stand-alone system that provides dosing recommendations and checks for drug-allergy interactions, drug-drug interactions, and duplicate drugs, as well as constant technical assistance from MedAllies (Fishkill, NY, USA), a health information technology (HIT) service provider.

In all, the researchers reviewed 3,684 paper-based prescriptions at the start of the study and 3,848 paper-based and electronic prescriptions written one year later. In that period, the percentage of prescription errors dropped from 42.5% to 6.6% for the providers that switched to using the electronic system. For those who continued writing prescriptions by hand, the percentage of errors increased slightly from 37.3% to 38.4%. The researchers found that illegibility problems were eliminated by e-prescribing. The study was published ahead of print on February 26, 2010, in the Journal of General Internal Medicine.

"We found nearly two in five handwritten prescriptions in these community practices had errors,” said lead author associate professor Rainu Kaushal, M.D., M.P.H, chief of the division of quality and medical informatics. "Examples of the types of errors we found included incomplete directions and prescribing a medication but omitting the quantity. A small number of errors were more serious, such as prescribing incorrect dosages.”

"Although most of the errors we found would not cause serious harm to patients, they could result in callbacks from pharmacies and loss of time for doctors, patients, and pharmacists,” added senior author assistant professor Erika Abramson, M.D., of the department of pediatrics. "On the plus side, we found that by writing prescriptions electronically, doctors can dramatically reduce these errors and therefore these inefficiencies.”

The researchers noted that without extensive technical support, it is difficult for physician practices to achieve high rates of use of electronic prescribing and subsequent improvements in medication safety.

Related Links:
Weill Cornell Medical College
MedAllies