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Electronic prescribing: risk of potentially harmful errors

Electronic prescribing is supposed to improve the various stages of medication use. But it can also result in potentially harmful errors. Healthcare professionals have a crucial monitoring role to play.

One of the hopes for computerisation in the field of health care was that it would improve the various stages of medication use, with improvements in legibility, integration of various safeguards, and faster communication.

But numerous errors occur with electronic prescribing (or computerised physician order entry, CPOE). Some of these errors are similar to those seen with handwritten prescriptions, while others are specific to electronic prescribing and arise through complex mechanisms.

Software bugs, computer failure and unreliable or slow internet connections can lead to errors and data loss. The way information is displayed on the screen, often too dense, is also a source of errors.

Inputting text outside a field subject to checks – which is often used to bypass a problem – runs the risk of not identifying contradictory instructions. The default completion of some data fields can also lead to errors.

Errors and adverse effects attributed to electronic prescribing are often due to a combination of factors, both technical and human. For example: inadequate training on the software programme; rolling out the computerised process too hastily; jumbled presentation of information on the screen; failure to verify a patient’s identity; having several patient files open at the same time; inappropriate settings.

Electronic prescribing sometimes leads to overconfidence. Human monitoring by healthcare professionals remains crucial.

©Prescrire 1 July 2016

"Electronic prescribing: errors due to multiple causes" Prescrire Int 2016; 25 (173): 189-193. (Pdf, subscribers only).

Download the full review.
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See also:

Electronic prescribing:
the risk of errors and
adverse effects
Prescrire Int 2016;
25 (167): 24-27.
Pdf, subscribers only