While the chance of error with electronically sent prescriptions are not higher than those written by hand, they are also no lower, according to Karen Nanji, M.D., a researcher from Massachusetts General Hospital in Boston writing in the Journal of American Medical Information Association. Nanji explained that technology, in and of itself, does not eliminate the risk of errors.
Nanji and her research team evaluated 3,850 electronic prescriptions from three pharmacy chain outlets in Florida, Massachusetts, and Arizona made over a four-week period in 2008. The prescriptions all came from outpatient computerized prescribing systems at non-hospital doctors’ offices. The prescriptions were checked for medical errors by a clinical panel, who also determined if any of the prescription errors could potentially harm patients.
11.7 percent of the prescriptions (or 452 of the 3,850) had an error of some type. 4 percent of the prescriptions (or 163) had errors that could potentially cause harm to a patient. The researchers noted that this is no better than the error rate found in handwritten prescriptions. They wrote, “Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful use of the system does not decrease medication errors.”
Of the prescription errors, 17.3 percent were for anti-infectives. Errors in prescriptions for nervous system medications came in second as far as error rate, and those were followed by respiratory drugs.
In terms of errors which might cause an adverse reaction, nervous system, cardiovascular and anti-infective medications were the highest. In fact, a high number of errors were simply dosage emission. In the vast majority of cases (60.7 percent), the errors were omissions of drug dose, duration, and frequency.
The authors of the report detailed some ways that errors could be reduced in electronic prescriptions. For example, the system could be programmed to invalidate a prescription that does not have any dosage information. They also recommended that systems be built with built-in calculators so a prescriber doesn’t have to calculate the correct dosage himself or herself.
The study had limitations. The authors noted that they weren’t able to tell if a prescription was a “true electronic prescription,” meaning that it was transmitted from a computer in a physician’s office to a pharmacy’s computer, or whether it was printed out and then physically brought to the pharmacy.
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