Medication Malpractice Newsroom

Information Technology Has Been Shown To Reduce Medication Errors

Information technology has been shown to reduce medication errors and associated ADEs at every stage in medication administration.1 Information systems include decision support at the prescription stage, computerized physician order entry, unit dosing systems, and bar-coding of individual medications among others. We developed a computer simulation model and used it to evaluate the effectiveness of a number of information technology applications, individually and collectively, to reduce medication errors and associated ADEs.2 The model incorporated estimates from published studies of the potential reduction in medication errors that could result from implementation of various information technologies.

Shojania questions two of these estimates, specifically potential reductions in errors from implementing bar-coding and unit dosing. We assumed that bar-coding medications potentially could reduce drug administration errors by as much as 60%. This estimate is supported by other studies. Puckett3 reports on the effect of the introduction of CliniCare, a point-of-care information system for medication management, in a primary and tertiary care center. All medications were bar-coded and scanned at or near the patient’s bedside. He reports a medication error rate of 0.17% before implementation of the system. In the following year the medication error rate dropped by 59% to 0.07% and during the next year to 0.05%, a 70% decrease.

We estimated that the introduction of a unit dose system could reduce errors by as much as 80%. Unit dose systems dispense most medications from the pharmacy in a ready-to-administer form and are widely used in U.S. hospitals. Studies that have evaluated the impact of unit-dose dispensing on medication errors report reduction in medication error rates ranging from 53% to 85%.4–7

However, as Shojania points out, other studies have demonstrated mixed results from implementing some of these technologies. For example, an ethnographic study of the implementation of bar-code medication administration (BCMA) in several hospitals, while not reporting medication error rates before and after implementation, found several side effects that created the potential for new ADEs.8