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Research Article

Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study

  • Johanna I. Westbrook mail,

    J.Westbrook@unsw.edu.au

    Affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia

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  • Margaret Reckmann,

    Affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia

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  • Ling Li,

    Affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia

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  • William B. Runciman,

    Affiliation: School of Psychology, Social Work & Social Policy, University of South Australia, Adelaide, Australia

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  • Rosemary Burke,

    Affiliation: Pharmacy Department, Concord Repatriation General Hospital, Sydney, Australia

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  • Connie Lo,

    Affiliation: Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia

    Current address: Information Management and Technology Division, Sydney South West Area Health Service, Sydney, Australia

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  • Melissa T. Baysari,

    Affiliation: Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia

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  • Jeffrey Braithwaite,

    Affiliation: Centre for Clinical Governance Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia

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  • Richard O. Day

    Affiliation: Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, and Faculty of Medicine, University of New South Wales, Sydney, Australia

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  • Published: January 31, 2012
  • DOI: 10.1371/journal.pmed.1001164

Reader Comments (1)

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We measure what is measurable - but what of other categories of error?

Posted by sunilbhopal on 06 Feb 2012 at 05:40 GMT

Having prescribed on both the traditional paper chart, and one of the e-prescribing systems described in the paper, I read this with interest. The aim of the paper is to find errors - and the authors provide convincing evidence of what they term 'procedural' and 'clinical' errors. However, discussions with frustrated e-prescriber-colleagues, over many months, reveals that whilst these measurable error-rates decrease, others types of error spring up commonly, and probably unexpectedly.

One example is antibiotics with 'stop-dates', that stop without giving indication to the prescriber that they are no longer active - or "as needed" medications that a nurse may not be able to give because of incorrect prescribing. Other errors include drugs not appearing on a drug chart, despite the prescriber believing them to be prescribed.

These things are difficult to measure and I wonder if the conclusion that (I paraphrase) 'e-prescribing leads to reduction in error rates' may require more work to fully substantiate.

No competing interests declared.