JAMIA: E-prescribing with CDS significantly reduces errors
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Erika Abramson, MD, of the Weill Medical College of Cornell University, in Ithaca, N.Y., and her colleagues published their findings in the Dec. 5 issue of the Journal of the American Medical Informatics Association.
“The use of an e-prescribing system has the potential to reduce error rates markedly,” they wrote. “E-prescribing systems linked with advanced CDS may have an even bigger impact, especially on errors with higher potential for harm.”
Research focused particularly on prescribing errors made in ambulatory settings among community-based primary care providers. Researchers examined 9,385 prescriptions handwritten for 5,955 patients between September 2005 and November 2006 from 78 providers’ offices in New York and Massachusetts.
When instances of illegibility were accounted for, researchers determined that 212.6 prescribing errors occurred for every 100 prescriptions written. When instances of illegibility were discounted, researchers determined that 36.7 errors occurred for every 100 prescriptions written and that 27.8 percent of all prescriptions had at least one error.
Researchers predicted that, had providers been e-prescribing, all illegibility errors would not have happened. Additionally, they predicted that an e-prescribing system with basic CDS could have detected 32 percent of the remaining errors, and that an e-prescribing system with advanced CDS could have detected 57 percent of the remaining errors.
While many of the errors that researchers found were unlikely to result in serious patient harm, researchers wrote that “even the less serious errors are important to study for their impact on efficiency as well as patient safety.”
“Understanding the epidemiology of prescribing errors in the outpatient setting can inform strategies for reducing their frequency and severity,” they concluded.