Electronic Prescriptions

A retrospective study conducted by researchers at Massachusetts General Hospital in Boston revealed that 11.7% of electronic prescriptions contain one or more errors and are just as likely to contain errors as handwritten prescriptions. Electronic prescriptions have been marketed as a medication error reduction strategy and are increasingly being adopted in practice; however, this study provides information about some of the issues associated with electronic prescribing.

The researchers reviewed 3,850 electronic outpatient prescriptions that were sent to retail pharmacies in 3 states during one month in 2008. All of the electronic prescriptions originated from outpatient computerized prescribing systems in physicians’ offices. A panel comprised of clinicians reviewed the prescriptions for errors and found that 11.7% of the prescriptions contained one or more errors. The most common error was omission of information (60.7%).

The panel also determined whether the errors had the potential for patient harm and found that 4% of the electronic prescriptions had errors that they classified as significant or serious events; however none of the errors were life-threatening. The researchers noted that the error rate for the electronic prescriptions they reviewed was about the same as the error rate noted in published studies of handwritten prescriptions. Errors were most common in prescriptions for antimicrobial agents (17.3%) and the number, type, and severity of errors varied, which suggests that there is variability among the electronic prescribing systems in generating complete prescriptions and detecting errors and omissions.

Reference

Nanji KC, Rothschild JM, Salzberg C, et al. Errors associated with outpatient computerized prescribing systems. J Am Med Inform Assoc. 2011; Jun 29: e-pub ahead of print. Available online at jamia.bmj.com.