Computer prescribing systems risk patient safety

05/12/04

Prescribing safety features of general practice computer systems: evaluation using simulated test cases BMJ Volume 328, pp 1171-2; and Commentary: computer aided prescribing leaves holes in the safety net BMJ Volume 328, pp 1172-3

Computer prescribing systems are putting patients at risk by failing to warn of potentially serious errors, warn researchers in this week's BMJ.

The NHS Information Authority regulates the use of general practice computer systems, but these contain only general references to safety and there is evidence that they do not prevent contraindicated prescribing.

Researchers in Edinburgh, Kent and Nottingham tested four computer systems currently in use in about three quarters of UK general practices. All of them failed to detect known prescribing errors, especially where drugs were contraindicated.

One solution to this problem is to have more explicit regulations about when suppliers should implement alerts, say the authors. This would require regular dialogue between suppliers and users.

Many of the problems uncovered could be resolved, and this work is now being undertaken by the National Patient Safety Agency, they conclude.

Although computers can reduce medication error rates by as much as 60%, patients still die from the remaining errors, writes an expert in an accompanying commentary. But timely and relevant warnings will prevent disaster.

Hospital systems already exist that link patient history, laboratory results, and prescribing data and that present a hierarchy of warnings to inform, and occasionally forbid the prescriber to continue.

"Those who walk the therapeutic tightrope in general practice will want the assurance of a safety net that will catch important errors before they harm patients, an assurance that current systems cannot provide," he concludes.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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