Data entry is a top cause of medication errors

Training and design are seen as keys to reducing electronic prescribing errors.

By Andis Robeznieks, AMNews staff. Jan. 24, 2005.

Computerized prescribing systems might cut the quantity and severity of medication mistakes, but they can't eliminate them entirely, said patient safety experts who reviewed the U.S. Pharmacopeia's 5th annual study of medication error reports.

The study of the more than 235,000 error reports submitted in 2003 by 570 health care facilities was the largest ever by USP. And as the number of reported errors goes up, the percentage that causes patient harm has gone down. But the findings that generated the most discussion are those indicating that electronic prescribing is creating new types of errors.

"Computer entry" was the fourth-leading cause of errors, accounting for 13% (27,711) of the medication errors reported in 2003. In contrast, illegible or unclear handwriting was the 15th-leading cause, and accounted for 2.9% (6,134) of reported errors.

"It could be expected that handwriting would move down the list as computerization becomes more widely implemented, but what is surprising is that a new type of error is replacing handwriting," said Diane Cousins, vice president for USP Center for the Advancement of Patient Safety. "I was shocked to see computer entry moving up to fourth. The fact that it's moving up is a disturbing thing."

What this also shows, some experts said, is that implementing electronic systems requires physician input on design and extensive training with frequent refresher courses.

"It doesn't mean it's unsafe to use technology, it means we have human beings making computer errors," said Institute for Safe Medication Practices Executive Director Allen Vaida, PharmD. "When you use IT correctly, it helps reduce errors that reach patients, but there are still errors."