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The implementation of computerized information systems in hospitals allows implementations of automated surveillance systems to detect adverse drug events and computerized physician order entry (CPOE) systems to reduce medication errors.
Many of medical errors can be prevented and corrected. Failures such as lack of information on the drug, lack of information on the patient, misunderstanding physician’s prescription, failures to identify drug correctly, to check for allergies, to track medication orders can be prevented by providing sufficient, appropriate, timely and accurate information to medical professionals.
Computerized prescribing systems lowers the probability that a physician will make errors by providing information on the drug, on the patient and on possilbe drug interactions or allergy reactions at the time the physician make a medication order.
Ward clerks, or nurses make 80% of the errors in transcribing doctor’s handwriting. Entering medication order directly into the computerized physician order entry system without going through the transcribing process can reduce errors by 40%-60%.
Many of medical errors involve drug substitutions during the administration stage. Implementation of bar-coding can potentially prevent these types of errors.
Unit-dosing systems can be used to prevent over- or under-dose. Unit-dosing systems dispense drugs in single unit or unit-dose package, designed appropriately for each patient. This system can potentially reduce medical errors due to wrong doses by 80%.
Anderson et al. (2002) constructed a simulation model to estimate how the implementation of information technology on medical errors and adverse drug events. The model is a realistic representation of the medication delivery system in a hospital. The four stages of the medication delivery system are described in details, namely, prescribing, transcribing, dispensing, and administering drugs. Anderson et al. (2002) estimated that an integrated medication delivery system will reduce hospitalization by 1226 days and health care cost by $1.4 million annually in a large hospital. Medication errors can be potentially reduced to 38.3 and ADEs to about 9.4 per 1000 medication orders.
Use of health information technology will not only prevent adverse drug events due to medical errors but also allow detect errors so corrective actions can be taken.
D.W. Bates, Medication errors: How common are they and what can be doneto prevent them? Drug Safe 5 (1996) 303–310.
D.W. Simborg and H.J. Derewicz, A highly automated hospital medication system: Five years’ experience and evaluation, Annals of Internal Medicine 83 (1975) 342–346.
Evaluating the Capability of Information Technology to Prevent Adverse Drug Events: A Computer Simulation Approach. James G. Anderson, PhD, Stephen J. Jay, www.jamia.org/cgi/content/abstract/9/5/479
Preventing Medical Errors: Use of Information Technology To Reduce Adverse Drug Events
In this series of articles we review the impact of medical errors and adverse drug events, and discuss the possible solutions to this expanding problem in health care.