An unintended consequence of electronic prescriptions: prevalence and impact of internal discrepancies.
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.
Palchuk
Matvey B
MB
Harvard Medical School, Boston, Massachusetts, USA.
Fang
Elizabeth A
EA
Cygielnik
Janet M
JM
Labreche
Matthew
M
Shubina
Maria
M
Ramelson
Harley Z
HZ
Hamann
Claus
C
Broverman
Carol
C
Einbinder
Jonathan S
JS
Turchin
Alexander
A
D000555:Ambulatory Care Information Systems; D020000:Decision Support Systems, Clinical; D055695:Electronic Prescribing; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D008509:Medication Systems; D011786:Quality Control; D012189:Retrospective Studies; D014481:United States