Research funded by grants from the National Institutes of Health and the U.S. Agency for Healthcare Research and Quality concludes that electronic prescribing as opposed to manual prescribing actually increases medication errors in many cases, and dramatically so. The study results appear in an article just published in the Journal of the American Medical Informatics Association.

The research authors, from the University of Wisconsin-Madison and Geisinger Health System, examined the computerized physician order entry ("CPOE") systems in two intensive care units at a Northeast teaching hospital.

What they found was revealing, namely, that (1) identical prescription orders increased at a rate more than four times higher than was the case prior to CPOE implementation, and (2) same-medication mistakes jumped by more than 600 percent.

Specifically, researchers saw many cases where two orders were placed by different providers making rounds, within minutes of each other; where an order for the same medication was given during a shift change, resulting in duplicate orders and confusion; where a doctor ignored or overrode a system alert concerning a duplicate order; and where the electronic health record database could not recognize instances where an oral and intravenous form of a drug was actually the same medicine.

As to how to improve those shortcomings, the study states that a number of steps must be taken together and in a consciously unified manner. They include better database information that is more refined and that can better identify similarities and differences between drugs; an enhanced alert system that will more quickly and effectively get the attention of doctors; and better face-to-face communication among medical staff during shift changes and when a patient is handed off.

Related Resource: Information Week, "E-Prescribing May Increase Medication Errors" Aug. 12, 2011