Electronic Prescribing Systems Are Error-Prone, Survey Finds

The very technology created to reduce medication prescribing errors has been shown to have subpar results in catching drug interactions, dosage mistakes, and other errors, according to a new report.

In data collected in an annual patient safety survey, 39 percent of potentially harmful drug orders weren’t flagged by computerized physician order entry (CPOE) systems to alert staff of potential errors, according to the patient safety watchdog Leapfrog. The systems missed medications ordered for the wrong condition, or mistakes in dosage. What’s more, the systems failed to detect close to 13 percent of errors that could have resulted in the death of a patient, researchers found.

The study involved 1,500 hospitals, which were asked to test their systems by entering information for “dummy patients” and then submit medication information to learn what kinds of errors the hospitals’ systems detected.

“Hospitals spend millions of dollars to implement CPOE systems, but our results clearly show that many hospitals’ systems are not operating as well as they should, putting patients’ lives at risk,” Leah Binder, president and CEO of Leapfrog said in a press release with the study.

Additional findings include:

  • Almost every reporting hospital now has a CPOE system
  • Nearly all (96 percent) of hospitals report adoption of a CPOE system, up from 33 percent in 2010
  • Among the states with the lowest percentage of hospitals meeting Leapfrog’s standard – CPOE systems that alert physicians to at least 50 percent of common, serious prescribing errors and process at least 75 percent of all medication orders – were Indiana (25 percent) and Nevada (35 percent).

According to Kaiser Health News, however, Leapfrog surveys on CPOE and other patient safety factors, have their critics, and this survey was not peer reviewed. Erica Mobley, Leapfrog’s director of development and communications, told Kaiser that in this particular survey, the survey may inflate the number of hospitals with a computer-based medication ordering system.

Still, patient safety researchers, such as Raj Ratwani, the scientific director for MedStar Health’s National Center for Human Factors in Healthcare, said the Leapfrog results aren’t surprising.

“What these findings indicate — and what many other researchers have shown — is that computerized physician order entry is effective at reducing adverse drug events,” Ratwani told Kaiser. “What we also know … is these electronic health record systems are complex.”

Mary Butler is the associate editor at The Journal of AHIMA.

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