Electronic prescriptions reduce errors sevenfold

Clinicians using an electronic system to write prescriptions were seven times less likely to make errors than those writing prescriptions by hand.

To evaluate the effects of e-prescribing on medication safety, researchers looked at prescriptions written by clinicians at 12 community practices in the Hudson Valley region of New York. The authors compared the number and severity of prescription errors between 15 clinicians who adopted e-prescribing and 15 who continued to write prescriptions by hand. The study was published online Feb. 26 by the Journal of General Internal Medicine.

Researchers conducted a prospective, non-randomized study using pre-post design of 15 clinicians who adopted e-prescribing with concurrent controls of 15 paper-based clinicians from September 2005 through June 2007. Authors reviewed 3,684 paper-based prescriptions at the start of the study and 3,848 paper-based and electronic prescriptions at one year of follow-up.

For e-prescribing adopters, error rates decreased nearly sevenfold, from 42.5 per 100 prescriptions (95% CI, 36.7 to 49.3) at baseline to 6.6 per 100 prescriptions (95% CI, 5.1 to 8.3) one year after adoption (P<0.001). For non-adopters, error rates remained at 37.3 per 100 prescriptions (95% CI, 27.6 to 50.2) at baseline and 38.4 per 100 prescriptions (95% CI, 27.4 to 53.9) at one year (P=0.54). Examples included incomplete directions and prescribing a medication but omitting the quantity. A small number of errors were more serious, such as prescribing incorrect dosages. Although most errors would not seriously harm patients, they'd likely result in callbacks and lost time.

E-prescribing completely eliminated illegibility errors (87.6 per 100 prescriptions at baseline for e-prescribing adopters, 0 at one year).

All the practices that adopted e-prescribing received technical assistance from a health information technology service provider. The study noted that, without extensive technical support, it is difficult for practices to implement e-prescribing.