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Study finds computerized ordering may increase error

Patient Safety Monitor Alert, March 16, 2005

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Researchers at the University of Pennsylvania found that a leading electronic system increased the risk of 22 types of prescription error, reports the Baltimore Sun. Such errors included ordering the wrong dosage, failing to renew a medication on time, and prescribing a drug for the wrong patient.

The findings were published March 9 in the Journal of the American Medical Association.

Previous studies have shown that computerized physician order entry (CPOE) systems can reduce errors by up to 81%. But the systems are not infallible, say patient safety experts.

"With any CPOE system, no matter how well it's designed, there will be new errors occuring that didn't exist in the handwritten system," said Fran Griffin, director of patient safety projects at the Institute for Healthcare Improvement, which was not involved in the study.

"Technology offers an awful lot of promise, but this blind faith in it is often just lethal," said Ross Koppel, lead author of the study. He and his colleagues shadowed residents and attending physicians and nurses at the Hospital of the University of Pennsylvania from 2002 until last year. Koppel also surveyed 261 residents about their use of CPOE.

Almost 75% reported being uncertain about drugs or dosages because they couldn't view all of the patient's medications on a single screen. More than 25% reported that a few times a week, patients didn't get antibiotics on time because the computerized system didn't remind doctors to reapprove the orders. A note in the paper chart previously served as a reminder for physicians to reapprove orders.

To read the complete Baltimore Sun article, click here.

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