E-prescribing systems prevent more errors than they cause, study says

An audit of two electronic prescribing systems (e-PS) found frequent system-related errors. But the audit, published online in the Journal of the American Medical Informatics Association, found that only a small percentage of those errors were serious and that e-PS prevent more errors than they create.

Researchers from the University of New South Wales, Sydney, Australia, audited 629 inpatient admissions at two hospitals in Sydney. The hospitals used the CSC MedChart and Cerner Millennium e-PS. The error rate did not significantly differ by e-PS.

The audit found that 42.4% of the 1164 prescribing errors identified were system related. However, only a small percent of those errors, 2.2%, were serious errors. Of those serious errors, the study found that 13.4% were detected and corrected prior to the audit.

The system-related errors included timing errors (27.4%), wrong doses (22.5%), selecting incorrect items from drop-down menus (43.4%), editing errors (21.1%), and failure to complete new e-PS tasks (32%.)

Researchers concluded that e-PS designs with fewer drop-down menu selections might reduce errors. “Our findings demonstrate that system-related errors were most frequent when prescribers needed to select information from drop-down menus, edit information within the system, and perform new tasks not previously required,” wrote Johanna Westbrook, professor, Faculty of Medicine, Centre for Health Systems and Safety Research, University of New South Wales. “This suggests that e-PS designed with fewer opportunities for selection errors, that is, by guiding users to select from predefined order sentences, may be beneficial.”

The study concluded that because e-PS create new tasks for prescribers they create additional cognitive load and error opportunities.