An unintended consequence of electronic prescriptions: prevalence and impact of internal discrepancies.

Harvard Medical School, Boston, Massachusetts, USA.
Journal of the American Medical Informatics Association (Impact Factor: 3.93). 07/2010; 17(4):472-6. DOI: 10.1136/jamia.2010.003335
Source: PubMed

ABSTRACT Many e-prescribing systems allow for both structured and free-text fields in prescriptions, making possible internal discrepancies. This study reviewed 2914 electronic prescriptions that contained free-text fields. Internal discrepancies were found in 16.1% of the prescriptions. Most (83.8%) of the discrepancies could potentially lead to adverse events and many (16.8%) to severe adverse events, involving a hospital admission or death. Discrepancies in doses, routes or complex regimens were most likely to have a potential for a severe event (p=0.0001). Discrepancies between structured and free-text fields in electronic prescriptions are common and can cause patient harm. Improvements in electronic medical record design are necessary to minimize the risk of discrepancies and resulting adverse events.

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