An unintended consequence of electronic prescriptions: prevalence and impact of internal discrepancies

被引：47

作者：

Palchuk, Matvey B. ^{[3
,4
]}

Fang, Elizabeth A. ^{[2
,3
]}

Cygielnik, Janet M. ^{[3
]}

Labreche, Matthew ^{[1
]}

Shubina, Maria ^{[3
]}

Ramelson, Harley Z. ^{[3
,4
]}

Hamann, Claus ^{[3
,4
]}

Broverman, Carol ^{[3
]}

Einbinder, Jonathan S. ^{[3
,4
]}

Turchin, Alexander ^{[3
,4
]}

机构：

[1] Northeastern Univ, Boston, MA 02115 USA

[2] Johns Hopkins Univ Hosp, Baltimore, MD 21287 USA

[3] Partners HealthCare Syst Inc, Boston, MA USA

[4] Harvard Univ, Sch Med, Boston, MA USA

来源：

JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION | 2010年 / 17卷 / 04期

关键词：

PHYSICIAN ORDER ENTRY; ADVERSE DRUG EVENTS; HEALTH-CARE; ERRORS;

D O I：

10.1136/jamia.2010.003335

中图分类号：

TP [自动化技术、计算机技术];

学科分类号：

0812 ;

摘要：

Many e-prescribing systems allow for both structured and free-text fields in prescriptions, making possible internal discrepancies. This study reviewed 2914 electronic prescriptions that contained free-text fields. Internal discrepancies were found in 16.1% of the prescriptions. Most (83.8%) of the discrepancies could potentially lead to adverse events and many (16.8%) to severe adverse events, involving a hospital admission or death. Discrepancies in doses, routes or complex regimens were most likely to have a potential for a severe event (p=0.0001). Discrepancies between structured and free-text fields in electronic prescriptions are common and can cause patient harm. Improvements in electronic medical record design are necessary to minimize the risk of discrepancies and resulting adverse events.

引用

页码：472 / 476

页数：5

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