ePrescription for safer medications
Charles Wright, eHealthCentral
“Today’s Sydney Morning Herald picks up on a study that showed electronic prescribing systems in two Australian teaching hospitals dramatically reduced medication errors.
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Medication Errors
Electronic prescription system could help cut errors
Amy Corderoy, smh.com.au
“Electronic prescribing systems could drastically cut previously intractable hospital medication errors, a study of two Sydney hospitals has found.
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Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study
Westbrook JI et al, PLoS Med, 9(1)
Background
Considerable investments are being made in commercial electronic prescribing systems (e-prescribing) in many countries. Few studies have measured or evaluated their effectiveness at reducing prescribing error rates, and interactions between system design and errors are not well understood, despite increasing concerns regarding new errors associated with system use. This study evaluated the effectiveness of two commercial e-prescribing systems in reducing prescribing error rates and their propensities for introducing new types of error.
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One quarter of seniors taking 10 or more medications
Theresa Boyle, The Star
“Canadian seniors are consuming a startling amount of prescription medications, says a new report, revealing almost two-thirds take five or more drugs a day and one-quarter take a whopping 10 or more.
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Mostashari responds to IOM report
Joseph Conn, ModernHealthcare
“The nation’s health IT czar, responding to the early release Tuesday of the Institute of Medicine’s report on patient-safety issues linked to the use of healthcare information technology, said IT glitches should not overshadow IT systems’ contributions toward improving patient safety.
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Institute Of Medicine Slams Sellers Of Electronic Health Records
Zina Moukheiber, Forbes
“The government-mandated push to implement electronic health records is supposed to centralize patient data, and reduce human medical errors in the process. However, EHRs can introduce a different set of errors, namely software glitches.
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Research finds GP e-prescribing errors
Shanna Crispin, e-Health Insider
“New research has found that more than 4% of electronic prescriptions written by general practitioners contain errors.
Researchers from Reading University have been studying prescription data from 15 general practices over the past 18 months and are on the verge of publishing the results.
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Inspectie eist uitwisseling patiëntengegevens in 2013
“De Inspectie voor de Gezondheidszorg (IGZ) eist dat zorgverleners uiterlijk in 2013 de uitwisseling van medische gegevens van patiënten verbeteren. Anders krijgen huisartsen, apothekers, ziekenhuizen en verpleeghuizen zo’n uitwisselingssysteem opgelegd. Dat zegt de IGZ in het vandaag verschenen rapport De Staat van de Gezondheidszorg 2011.
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La historia clínica de Osakidetza reduce el 67% los errores asociados a la medicación
Apiscam
“Osabide Global, la historia clínica electrónica única de Osakidetza, ha sido reconocida con el premio a la mejor experiencia sanitaria para la mejora de la calidad y la seguridad de los pacientes en España, reconocimiento que otorga la Sociedad Española de Calidad Asistencial, SECA, referencia nacional en la materia.
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Electronic prescribing within an electronic health record reduces ambulatory prescribing errors
Abramson EL et al, Joint Commission Journal on Quality and Patient Safety, 37(10)
BACKGROUND
Health policy forces are promoting the adoption of interoperable electronic health records (EHRs) with electronic prescribing (e-prescribing). Despite the promise of EHRs with e-prescribing to improve medication safety in ambulatory care settings–where most prescribing occurs and where errors are common–few studies have demonstrated its effectiveness. A study was conducted to assess the effect of an e-prescribing system with clinical decision support, including checks for drug allergies and drug-drug interactions, that was integrated within an EHR on rates of ambulatory prescribing errors.
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Closing information gaps with shared electronic patient summaries––How much will it matter?
Remen VM, Grimsmo A. International Journal of Medical Informatics, 80(11)
Background
Information deficits contribute to medical errors. Hence several efforts to develop electronic communication systems to facilitate a flow of information between health care providers have been attempted, including initiatives to develop regional or national electronic patient summaries.
Objectives
To study information access and information needs in inpatient emergency departments, and how clinicians in these departments handle deficits in available information.
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Better hospital IT ‘would save thousands of lives’
Adam Brimelow, BBC News
“Better use of information technology in England’s hospitals could help prevent 16,000 deaths a year, a report says.
University Hospitals Birmingham has recommended its system to the team investigating above-average death rates from 2005 to 2008 at Stafford Hospital.
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Electronic prescriptions shown to be more complete than written prescriptions
OSN SuperSite
“Electronic prescriptions appeared to be more complete than two types of written prescriptions, a study found.
“Our results support the view that electronic prescribing is an essential tool for ensuring completeness of information and highlight the importance of prescription design and the impact this can have on reducing prescription errors,” the study authors said. “If written prescriptions must be used, we recommend the inclusion of information prompts in their design.”
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Electronic prescribing and prescription design in ophthalmic practice
Connor AJ et al, European Journal of Ophthalmology, 21(5)
Purpose.
Prescription and drug errors are common causes of adverse clinical events, posing a significant risk to safe patient care. Although there has been a movement to increase the use of electronic prescribing, concerns over feasibility suggest that improving the design of written prescriptions to minimize missing information may still be worthwhile. This retrospective cross-sectional study examined the effect on prescription completeness of electronic prescriptions and adding information prompts to written prescriptions. We hypothesized that electronic prescription would be superior to written prescriptions on prescription completeness and the inclusion of information prompts in written prescriptions would result in increased recording of the prompted information.
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Digital doctors: Will technology help or harm?
David Gulliver, Bradenton Herald
“At Blake Medical Center, the prognosis for pen and paper is poor: Doctors’ traditional tools for tracking cases and ordering medications and procedures are being phased out in favor of computers.
To Dr. Joe Pace, a cardiologist, it’s a tremendous boon.
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Trial shows medical app reduces errors in emergency situations
Satish Misra, iMedicalApps
“The moment where a patient’s pulse slips from faint to absent or the rise and fall of their chest becomes imperceptible is perhaps the most stressful, emotionally charged situation in medicine. It naturally, therefore, lends itself to chaos – and chaos plus emotion does not lead to good outcomes. A recent study suggests that medical apps could help help providers overcome these two obstacles during medical emergencies, potentially improving outcomes for patients.
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Students prescribing emergency drug infusions utilising smartphones outperform consultants using BNFCs
Flannigan C, McAloon J. Resuscitation, 2011
OBJECTIVE:
To compare the use of a drugs calculator on a smartphone with use of the British National Formulary for Children (BNFC) for accuracy, speed and confidence of prescribing in a simulated paediatric emergency.
DESIGN:
28 doctors and 7 medical students in a paediatric department of a District General Hospital, were asked to prescribe both a dopamine infusion and an adrenaline infusion for a hypotensive child. For one calculation they used the BNFC as their reference source and for the other they used the ‘PICU Calculator’ on the iPhone.
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E-Prescribing May Increase Medication Errors
Neil Versel, InformationWeek
“Computerized physician order entry (CPOE), backed with clinical decision support (CDS), has long been considered an essential component of an electronic health record (EHR) because it is supposed to decrease duplication of orders and help prevent medical errors. But a new study suggests that some CPOE systems could be having exactly the opposite effect.
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Computerized prescriptions only as good as the system and user
Pamela Lewis Dolan, amednews
“Does typing a prescription into a computer mean automatically reducing the risk of medication errors, compared with the old-fashioned written script?
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Application of electronic health records to the Joint Commission’s 2011 National Patient Safety Goals
Radecki RP, Sittig DF. JAMA, 306(1)
Since publication of To Err Is Human, electronic health records (EHRs) and related health information technologies have been promoted as means to improve patient safety. This promise remains largely unfulfilled. For instance, whereas EHRs with clinical decision support (CDS) interventions integrated into computerized physician order entry (CPOE) have measurably improved clinicians’ performance on process metrics, their effect on patient outcomes remains unconfirmed.
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