Addition of electronic prescription transmission to computerized prescriber order entry: Effect on dispensing errors in community pharmacies.
This article was published in 2011 in American Journal of Health-System Pharmacy.
The study measured the impact of e-prescribing transmission functionality on the rate of dispensing medication errors in an ambulatory care setting. The number of medication dispensing errors is on the rise. Possible reasons are increasing prescription volumes per pharmacy, provider fatigue, frequent workflow interruptions within pharmacies, and sound-alike and look-alike medications.
The authors conducted a controlled, before-and-after trial in two control clinics and one clinic using the e-prescribing feature of CPOE. The purpose of the study was to measure the effect of electronic prescribing on medication dispensing errors. During electronic transmission, prescriptions generated by the CPOE system are electronically transmitted directly to pharmacies. It is believed that the electronic transmission of prescriptions can significantly reduce the rate of dispensing errors by eliminating pharmacist transcription and data entry. During the two-month intervention period, prescriptions at the control clinics continued to be printed and handed to patients. At the e-prescribing clinic, participating physicians' eligible prescriptions were electronically transmitted to participating pharmacies. Schedule II substances prescriptions were not eligible for electronic transmission. Also, paper prescriptions were sent to pharmacies that did did not have technology to accept e-prescriptions.
The study found no significant difference in the dispensing-error rates for the control clinics and for the e-prescribing clinic for prescriptions that were not electronically transmitted. However, during the intervention period for the e-prescribing clinic, the dispensing-error rate for e-precriptions was significatnly lower than the dispensing-error rate for prescriptions not electronically transmitted.
The results of the study clearly demonstrated that the electronic prescription transmission can reduce dispensing errors by about half. The authors suggest that most dispensing errors, such as wrong strength and dosage, occur during the transcription stage. Electronic transmission of prescriptions to pharmacies has error-preventing benefits and should be implemented in addition to CPOE.
Electronic prescription is an effective approach to reduce medical errors. Electronic prescription should be preferred in clinical practices.
Full integration between CPOE e-prescribing and the pharmacy system is needed.
- David W. Bates, Carol A. Keohane, Thomas T. Moniz, Jeffrey M. Rothschild, Andrew C. Seger and Diane Lew Seger.Addition of electronic prescription transmission to computerized prescriber order entry: Effect on dispensing errors in community pharmacies. http://go.galegroup.com.ezproxyhost.library.tmc.edu/ps/i.do?p=HRCA&u=txshracd2509&id=GALE%7CA249311289&v=2.1&it=r&sid=summon&userGroup=txshracd2509&authCount=1