Article

Potential benefits and problems with computerized prescriber order entry: Analysis of a voluntary medication error-reporting database

University of Maryland, Baltimore, Baltimore, Maryland, United States
American Journal of Health-System Pharmacy (Impact Factor: 1.88). 03/2006; 63(4):353-8. DOI: 10.2146/ajhp050379
Source: PubMed

ABSTRACT

The potential benefits and problems associated with computerized prescriber-order-entry (CPOE) systems were studied.
A national voluntary medication error-reporting database, Medmarx, was used to compare facilities that had CPOE with those that did not have CPOE. The characteristics of medication errors reportedly caused by CPOE were explored, and the text descriptions of these errors were qualitatively analyzed.
Facilities with CPOE reported fewer inpatient medication errors and more outpatient medication errors than facilities without CPOE, but the statistical significance of these differences could not be determined. Facilities with CPOE less frequently reported medication errors that reached patients (p < 0.01) or harmed patients (p < 0.01). More than 7000 CPOE-related medication errors were reported over seven months in 2003, and about 0.1% of them resulted in harm or adverse events. The most common CPOE errors were dosing errors (i.e., wrong dose, wrong dosage form, or extra dose). Both quantitative and qualitative analyses indicate that CPOE could lead to medication errors not only because of faulty computer interface, mis-communication with other systems, and lack of adequate decision support but also because of common human errors such as knowledge deficit, distractions, inexperience, and typing errors.
A national, voluntary medication error-reporting database cannot be used to determine the effectiveness of a CPOE system in reducing medication errors because of the variability in the number of reports from different institutions. However, it may provide valuable information on the specific types of errors related to CPOE systems.

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    • "• Reducing prescription, medication and transcription errors, adverse drug reaction (ADR), prescription fraud and litigation (48, 50, 53-61). "
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    ABSTRACT: The tendency to use advanced technology in healthcare and the governmental policies have put forward electronic prescription. Electronic prescription is considered as the main solution to overcome the major drawbacks of the paper-based medication prescription, such as transcription errors. This study aims to provide practical information concerning electronic prescription system to a variety of stakeholders. In this review study, PubMed, ISI Web of Science, Scopus, EMBASE databases, Iranian National Library Of Medicine (INLM) portal, Google Scholar, Google and Yahoo were searched for relevant English publications concerning the problems of paper-based prescription, and concept, features, levels, benefits, stakeholders and standards of electronic prescription system. There are many problems with the paper prescription system which, according to studies have jeopardized patients' safety and negatively affected the outcomes of medication therapy. All of these problems are remedied through the implementation of e-prescriptions. The sophistication of electronic prescription and integration with EHR will become a reality, if all its stakeholders collaborate in developing fast and secure electronic prescription systems. It is plausible that the required infrastructure should be provided for implementation of the national integrated electronic prescription systems in countries without the system. Given the barriers to the implementation and use, policymakers should consider multiple strategies and offer incentives to encourage e-prescription initiatives. This will result in widespread adoption of the system.
    Full-text · Article · Oct 2013
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    • "Frameworks to classify the problem, process and outcome of medication error reports are summarised in Tables 1–3 respectively. Introduction of electronic MMS that incorporate computerised physician order entry (CPOE) into a hospital inpatient setting is reported to reduce the incidence of serious medication error (Kaushal et al. 2003, Ash et al. 2004, Roach et al. 2004, Zhan et al. 2006). Reported benefits of MMS and CPOE include simplified prescription, selection and administration processes (Nolen & Rodes 2008), elimination of common communication and documentation errors attributed to incomplete, ambiguous or illegible hand-written medication orders (Seeley et al. 2004, Kuperman et al. 2007) and a decreased rate of non-intercepted serious medication errors (Bates et al. 1998, Kaushal et al. 2003). "

    Full-text · Dataset · Aug 2013
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    • "Frameworks to classify the problem, process and outcome of medication error reports are summarised in Tables 1–3 respectively. Introduction of electronic MMS that incorporate computerised physician order entry (CPOE) into a hospital inpatient setting is reported to reduce the incidence of serious medication error (Kaushal et al. 2003, Ash et al. 2004, Roach et al. 2004, Zhan et al. 2006). Reported benefits of MMS and CPOE include simplified prescription, selection and administration processes (Nolen & Rodes 2008), elimination of common communication and documentation errors attributed to incomplete, ambiguous or illegible hand-written medication orders (Seeley et al. 2004, Kuperman et al. 2007) and a decreased rate of non-intercepted serious medication errors (Bates et al. 1998, Kaushal et al. 2003). "

    Full-text · Dataset · Jan 2013
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