Medication Prescription Technology Can Have Adverse Effects on Medical Businesses and Patient Safety

According to the Academy of Managed Care Pharmacy (AMCP), drug errors are one of the most common medical mistakes, resulting in 1.5 million injuries each year. The AMCP suggests several electronic tools, including computerized physician order entry (CPOE), to prevent medication errors.

A CPOE permits doctors to enter prescription information using a standard format and transmits the data directly to the pharmacist. Some of these sophisticated computer systems also include an intervention alert that warns the doctor, nurse or pharmacist of potential problems with the treatment ordered. This technology helps prevent the following types of preventable pharmaceutical errors:

• Illegible handwriting on a prescription pad
• Mishearing similar-sounding drug names during oral communications
• Inconsistent use of abbreviations and terminology by different health care providers
• Incomplete information about co-prescribed drugs, past adverse interactions and allergies
• Ambiguous or omitted instructions for patient use
• Patient’s or hospital staff’s failure to fill a prescription
• Undocumented distribution of sample drugs to a patient

But CPOE software has limitations. Humans must still enter, interpret and act on data contained in a CPOE, and humans make errors. The AMCP states, “Preventable errors occur because systems for safely prescribing and ordering medication are not appropriately used.”

A CPOE can have unintended consequences that affect a medical facility’s operations and patient safety. A study published in the Journal of the American Medical Informatics Association (JAMIA) describes the following pitfalls of a computerized medication system:

• More work for hospital or clinic staff to manually enter data, attend to alerts and compile reports
• Elimination of process reviews to catch such problems as duplicate or contraindicated treatment orders
• Multiple entries of the same order by various staff members involved in a patient’s care
• A decline in face-to-face interaction between doctors, nurses and other medical practitioners that can result in miscommunication about a patient’s course of treatment
• Entry of incorrect information — for example choosing the wrong medication or wrong patient’s name from a preprogramed dropdown menu
• System crash can interrupt patient care

Overall, CPOEs reduce prescription errors. However, the technology may introduce new problems into the drug administration process. Hospitals and other entities should devise thoughtful risk mitigation solutions, policies and procedures to facilitate implementation of CPOE systems.

Tagged with: common medical mistakes, computerized physician order entry, fraud in the health care industry, medication errors, patient safety

• Posted on: May 6 2014