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Search results for "Electronic Health Records"
- Electronic Health Records
Journal Article > Study
Incidence of clinically relevant medication errors in the era of electronically prepopulated medication reconciliation forms: a retrospective chart review.
Stockton KR, Wickham ME, Lai S, et al. CMAJ Open. 2017;5:E345-E353.
An accurate list of patient medications is a necessary precursor for safe medication use. One strategy to improve medication reconciliation is to provide a list of dispensed outpatient medications to inpatient clinicians upon hospital admission via an electronic medication reconciliation process. This retrospective chart review study compared a research pharmacist–generated gold standard medication list to the actual medications ordered during an admission after such a process was implemented. The study team identified medication discrepancies between the pharmacist-generated and admission-ordered medication lists and noted any inappropriately prescribed or continued medications. Medication errors were present in nearly half of the patient records; about 9% of errors were clinically important. The authors raise concerns that electronically prepopulated medication reconciliation forms may actually adversely impact medication safety. A previous WebM&M commentary discussed how to enhance accuracy of medication reconciliation.
Journal Article > Study
Eguale T, Buckeridge DL, Verma A, et al. JAMA Intern Med. 2016;176:55-63.
Prescribing medications for indications that are not approved by the Food and Drug Administration—so-called off-label prescribing—is common. Although it is invariably well-intentioned, this population-based study demonstrates that off-label prescribing is a risk factor for medication errors. The study used the electronic medical record in Quebec that required physicians to enter the reason for prescribing or discontinuing medications to analyze the frequency of off-label prescribing and adverse events associated with this practice. Off-label prescribing was associated with a higher adverse drug event risk, especially when there was no convincing scientific indication for the unapproved use (which was the case in more than 80% of off-label prescriptions). The accompanying editorial notes that the FDA is under pressure to relax restrictions on marketing of drugs for off-label purposes and raises the concern that eliminating such restrictions could expose more patients to adverse events.
Journal Article > Review
The impact of electronic health records on time efficiency of physicians and nurses: a systematic review.
Poissant L, Pereira J, Tamblyn R, Kawasumi Y. J Am Med Inform Assoc. 2005;12:505-516.
Electronic health records (EHRs) represent a growing focus of federal initiatives to improve patient safety and quality. Successful implementation of these systems will depend on their capacity to effectively engage frontline personnel, in terms of both the system-user interface and workflow process. This systematic review discovered that EHRs reduced documentation time for nurses but increased it for physicians, particularly when using centrally located desktop workstations rather than bedside point-of-care systems. The latter finding of workstation choice is perhaps the most striking, as interpretation of overall documentation times is limited by the software design, user interface, and available decision support for a given system. While some systems undoubtedly perform better than others in this regard, efforts to implement EHRs will need to address the potential for increased physician documentation times and associated workflow. Only then will implementation of EHRs begin to achieve the downstream safety effects desired.
Electronically Generated Medication Administration and Electronic Medication Administration Records for the Prevention of Medication Transcription Errors: Review of Clinical Effectiveness and Safety.
Ottawa, ON: Canadian Agency for Drugs and Technologies in Health; 2016.
Society for Medical Decision Making. October 25–27, 2010; Sheraton Centre Toronto Hotel Toronto, Ontario, Canada.