Computerised prescribing for safer medication ordering: still a work in progress.

Gordon Schiff; Thu-Trang T Hickman; Lynn A Volk; David W Bates; Adam Wright

Commentary

Computerised prescribing for safer medication ordering: still a work in progress.

November 18, 2015

Schiff G, Hickman T-TT, Volk LA, et al. BMJ Qual Saf. 2016;25(5):315-9.

View more articles from the same authors.

The unintended consequences related to implementation of health information technologies have been widely documented. In this commentary, the authors offer insights regarding a government-funded investigation of 10 computerized provider order entry systems, discuss weaknesses in these systems, and make recommendations to focus on designing around human factors, enhancing workflow, and improving reporting.

PubMed citation

Available at

Related Resources From the Same Author(s)

Outpatient CPOE orders discontinued due to 'erroneous entry': prospective survey of prescribers' explanations for errors.

August 16, 2017

Analysis of variations in the display of drug names in computerized prescriber-order-entry systems.

May 24, 2017

Computerized prescriber order entry–related patient safety reports: analysis of 2522 medication errors.

October 19, 2016

Cranky comments: detecting clinical decision support malfunctions through free-text override reasons.

January 16, 2019

Analysis of clinical decision support system malfunctions: a case series and survey.

April 13, 2016

Association of note quality and quality of care: a cross-sectional study.

April 23, 2014

Problem list completeness in electronic health records: a multi-site study and assessment of success factors.

August 26, 2015

Screening for medication errors using an outlier detection system.

February 8, 2017

Incorporating medication indications into the prescribing process.

May 9, 2018

Reduced effectiveness of interruptive drug–drug interaction alerts after conversion to a commercial electronic health record.

May 30, 2018

Are physicians' perceptions of healthcare quality and practice satisfaction affected by errors associated with electronic health record use?

January 11, 2012

Comparison of a prototype for indications-based prescribing with 2 commercial prescribing systems.

May 1, 2019

Clinical decision support alert malfunctions: analysis and empirically derived taxonomy.

November 1, 2017

Using a machine learning system to identify and prevent medication prescribing errors: a clinical and cost analysis evaluation.

December 18, 2019

Can electronic clinical documentation help prevent diagnostic errors?

March 31, 2010

Using drug knowledgebase information to distinguish between look-alike-sound-alike drugs.

June 27, 2018

Incorporating indications into medication ordering—time to enter the age of reason.

August 10, 2016

How often do prescribers include indications in drug orders? Analysis of 4 million outpatient prescriptions.

July 10, 2019

Electronic health records and malpractice claims in office practice.

December 3, 2008

An effort to improve electronic health record medication list accuracy between visits: patients' and physicians' response.

March 19, 2008

Overrides of medication-related clinical decision support alerts in outpatients.

January 8, 2014

Physicians and electronic health records: a statewide survey.

March 21, 2007

A prescription for enhancing electronic prescribing safety.

December 12, 2018

Association of display of patient photographs in the electronic health record with wrong-patient order entry errors.

December 2, 2020

Ambulatory prescribing errors among community-based providers in two states.

December 21, 2011

Personal formularies of primary care physicians across 4 health care systems.

August 4, 2021

Standard practices for computerized clinical decision support in community hospitals: a national survey.

July 11, 2012

Learning from errors: analysis of medication order voiding in CPOE systems.

March 15, 2017

Current challenges in health information technology–related patient safety.

January 16, 2019

Effect of restriction of the number of concurrently open records in an electronic health record on wrong-patient order errors: a randomized clinical trial.

May 29, 2019

Ten principles for more conservative, care-full diagnosis.

October 10, 2018

Evaluation of harm associated with high dose-range clinical decision support overrides in the intensive care unit.

January 23, 2019

Primary care closed claims experience of Massachusetts malpractice insurers.

October 16, 2013

Characteristics of disease-specific and generic diagnostic pitfalls: a qualitative study.

February 9, 2022

Strategies for flipping the script on opioid overprescribing.

November 23, 2016

Prospective evaluation of medication-related clinical decision support over-rides in the intensive care unit.

February 28, 2018

Preventability of adverse drug events involving multiple drugs using publicly available clinical decision support tools.

February 8, 2012

Diagnosis and diagnostic errors: time for a new paradigm.

January 8, 2014

A 60-year-old man with delayed care for a renal mass.

May 18, 2011

Health apps and health policy: what is needed?

October 24, 2018

Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool.

May 15, 2013

How can we make diagnosis safer?

February 8, 2012

Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.

March 6, 2019

Evaluating ambulatory practice safety: the PROMISES Project administrators and practice staff surveys.

December 17, 2014

The vulnerabilities of computerized physician order entry systems: a qualitative study.

December 9, 2015

Impact of vendor computerized physician order entry in community hospitals.

February 22, 2012

The safety of inpatient health care.

January 25, 2023

COVID-19: making the right diagnosis.

August 5, 2020

The elusive and illusive quest for diagnostic safety metrics.

May 16, 2018

Looking back on the history of patient safety: an opportunity to reflect and ponder future challenges.

November 3, 2021

Advancing the research agenda for diagnostic error reduction.

August 28, 2013

John M. Eisenberg Patient Safety Awards. Research: David W. Bates, MD, MSc, Brigham and Women's Hospital.

March 6, 2005

Unexpected hypoglycemia in a critically ill patient.

March 15, 2006

Computerized physician order entry and medication errors: finding a balance.

July 6, 2005

Use of health information technology to reduce diagnostic errors.

August 21, 2013

Expert consensus on currently accepted measures of harm.

September 9, 2020

Randomized trial of reducing ambulatory malpractice and safety risk: results of the Massachusetts PROMISES Project.

July 19, 2017

What if?: Transforming Diagnostic Research by Leveraging a Diagnostic Process Map to Engage Patients in Learning from Errors.

March 4, 2020

Understanding test results follow-up in the ambulatory setting: analysis of multiple perspectives.

October 24, 2018

Health information exchange and patient safety.

November 7, 2007

Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial.

May 23, 2012

Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety.

November 7, 2018

Medication administration errors by nurses: adherence to guidelines.

January 30, 2013

Communication failure: analysis of prescribers' use of an internal free-text field on electronic prescriptions.

March 7, 2018

Evaluation and certification of computerized physician order entry systems.

November 22, 2006

Exploring the potential for using drug indications to prevent look-alike and sound-alike drug errors.

September 6, 2017

Association of hospital public quality reporting with electronic health record medication safety performance.

October 6, 2021

Quality and safety: learning from the past and (re)imagining the future.

March 29, 2023

Improving safety with information technology.

March 6, 2005

Orders on file but no labs drawn: investigation of machine and human errors caused by an interface idiosyncrasy.

March 22, 2017

Critical drug–drug interactions for use in electronic health records systems with computerized physician order entry: review of leading approaches.

June 15, 2011

Adverse events and near misses relating to information management in a hospital.

June 22, 2016

Incidence of adverse drug events and medication errors in Japan: the JADE Study.

November 3, 2010

Preventable adverse drug events and their causes and contributing factors: the analysis of register data.

February 16, 2011

Pediatric medication safety and the media: what does the public see?

June 21, 2006

The use of computers for clinical care: a case series of advanced US sites.

March 6, 2005

The global burden of diagnostic errors in primary care.

August 24, 2016

The need for closed-loop systems for management of abnormal test results.

April 25, 2018

Improving electronic health record usability and safety requires transparency.

December 12, 2018

Physician burnout in the electronic health record era: are we ignoring the real cause?

May 9, 2018

Why do we still page each other? Examining the frequency, types and senders of pages in academic medical services.

February 3, 2016

Racism and electronic health records (EHRs): perspectives for research and practice.

April 12, 2023

Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review.

July 18, 2007

What practices will most improve safety? Evidence-based medicine meets patient safety.

April 12, 2006

Beyond the prescription: medication monitoring and adverse drug events in older adults.

August 31, 2011

Essential activities for electronic health record safety: a qualitative study.

March 20, 2019

Digital health and patient safety.

April 27, 2016

Communicating critical test results: safe practice recommendations.

April 3, 2005

Safety of patients isolated for infection control.

March 27, 2005

Mixed results in the safety performance of computerized physician order entry.

April 21, 2010

The National Quality Forum safe practice standard for computerized physician order entry: updating a critical patient safety practice.

January 10, 2007

Benefits and risks of using smart pumps to reduce medication error rates: a systematic review.

October 22, 2014

Comparative accuracy of diagnosis by collective intelligence of multiple physicians vs individual physicians.

March 13, 2019

Design of a safety dashboard for patients.

December 18, 2019

Reasons for computerised provider order entry (CPOE)-based inpatient medication ordering errors: an observational study of voided orders.

July 26, 2017

Principles of conservative prescribing.

June 29, 2011

Exploring the roots of unintended safety threats associated with the introduction of hospital ePrescribing systems and candidate avoidance and/or mitigation strategies: a qualitative study.

February 22, 2017

Conflict of interest, Dr Charles Denham and the Journal of Patient Safety.

December 3, 2014

Can surveillance systems identify and avert adverse drug events? A prospective evaluation of a commercial application.

September 17, 2008

Assessing the safety of electronic health records: a national longitudinal study of medication-related decision support.

August 7, 2019

Related Resources

Indication documentation and indication-based prescribing within electronic prescribing systems: a systematic review and narrative synthesis.

April 5, 2023

Perspectives on Safety

Annual Perspective

Technology as a Tool for Improving Patient Safety

March 29, 2023

Improving administration and documentation of enteral nutrition support therapy in a Veteran Affairs health care system: use of medication administration record and bar code scanning technology.

February 1, 2023

Electronic prescribing systems in hospitals to improve medication safety: a multi-methods research programme.

December 21, 2022

Duplicate medication order errors: safety gaps and recommendations for improvement.

October 12, 2022

Free-text computerized provider order entry orders used as workaround for communicating medication information.

August 31, 2022

Comparing the variability of ingredient, strength, and dose form information from electronic prescriptions with RxNorm drug product descriptions.

August 31, 2022

Development and pilot evaluation of an electronic health record usability and safety self-assessment tool.

August 24, 2022

Medication orders with future start dates: how far away is too far?

July 27, 2022

The electronic prescribing of subcutaneous infusions: a before-and-after study assessing the impact upon patient safety and service efficiency.

June 15, 2022

Indication alerts to improve problem list documentation.

January 26, 2022

The effectiveness of interruptive prescribing alerts in ambulatory CPOE to change prescriber behaviour and improve safety.

May 5, 2021

A qualitative study of prescribing errors among multi-professional prescribers within an e-prescribing system.

December 23, 2020

How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis.

December 2, 2020

Safer prescribing for hospitalized older adults with an electronic health records‐based prescribing context.

October 28, 2020

A machine learning-based clinical decision support system to identify prescriptions with a high risk of medication error.

October 21, 2020

The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.

July 29, 2020

Effects of CPOE-based medication ordering on outcomes: an overview of systematic reviews.

July 8, 2020

How often do prescribers include indications in drug orders? Analysis of 4 million outpatient prescriptions.

July 10, 2019

When order sets do not align with clinician workflow: assessing practice patterns in the electronic health record.

June 19, 2019

Avoiding chemotherapy prescribing errors: analysis and innovative strategies.

February 13, 2019

The prevalence of dose errors among paediatric patients in hospital wards with and without health information technology: a systematic review and meta-analysis.

October 24, 2018

Impact of an inpatient electronic prescribing system on prescribing error causation: a qualitative evaluation in an English hospital.

July 11, 2018

Incorporating medication indications into the prescribing process.

May 9, 2018

Quality and variability of patient directions in electronic prescriptions in the ambulatory care setting.

April 18, 2018

From guideline to order set to patient harm.

April 4, 2018

WebM&M Cases

Slow Down: Right Drug, Wrong Formulation

January 1, 2018

Sustained user engagement in health information technology: the long road from implementation to system optimization of computerized physician order entry and clinical decision support systems for prescribing in hospitals in England.

November 1, 2017

A systematic review of the effectiveness of interruptive medication prescribing alerts in hospital CPOE systems to change prescriber behavior and improve patient safety.

September 27, 2017

Outpatient CPOE orders discontinued due to 'erroneous entry': prospective survey of prescribers' explanations for errors.

August 16, 2017

See More About The Topic

Hospitals

Health Care Executives and Administrators

Information Professionals

Medicine

Ordering/Prescribing Errors

Computerised prescribing for safer medication ordering: still a work in progress.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Computerised prescribing for safer medication ordering: still a work in progress.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

PSNet Log in

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site