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Qual Saf Health Care. Sep 2002; 11(3): 261–265.
PMCID: PMC1743646

Information technology and medication safety: what is the benefit?

Abstract



Medication errors occur frequently and have significant clinical and financial consequences. Several types of information technologies can be used to decrease rates of medication errors. Computerized physician order entry with decision support significantly reduces serious inpatient medication error rates in adults. Other available information technologies that may prove effective for inpatients include computerized medication administration records, robots, automated pharmacy systems, bar coding, "smart" intravenous devices, and computerized discharge prescriptions and instructions. In outpatients, computerization of prescribing and patient oriented approaches such as personalized web pages and delivery of web based information may be important. Public and private mandates for information technology interventions are growing, but further development, application, evaluation, and dissemination are required.

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Selected References

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  • Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, Hebert L, Newhouse JP, Weiler PC, Hiatt H. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med. 1991 Feb 7;324(6):377–384. [PubMed]
  • Thomas EJ, Studdert DM, Burstin HR, Orav EJ, Zeena T, Williams EJ, Howard KM, Weiler PC, Brennan TA. Incidence and types of adverse events and negligent care in Utah and Colorado. Med Care. 2000 Mar;38(3):261–271. [PubMed]
  • Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, Newhouse JP, Weiler PC, Hiatt HH. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med. 1991 Feb 7;324(6):370–376. [PubMed]
  • McDonald CJ, Weiner M, Hui SL. Deaths due to medical errors are exaggerated in Institute of Medicine report. JAMA. 2000 Jul 5;284(1):93–95. [PubMed]
  • Brennan TA. The Institute of Medicine report on medical errors--could it do harm? N Engl J Med. 2000 Apr 13;342(15):1123–1125. [PubMed]
  • Bates DW, Gawande AA. The impact of the Internet on quality measurement. Health Aff (Millwood) 2000 Nov-Dec;19(6):104–114. [PubMed]
  • Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, Laffel G, Sweitzer BJ, Shea BF, Hallisey R, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA. 1995 Jul 5;274(1):29–34. [PubMed]
  • Leape LL, Bates DW, Cullen DJ, Cooper J, Demonaco HJ, Gallivan T, Hallisey R, Ives J, Laird N, Laffel G, et al. Systems analysis of adverse drug events. ADE Prevention Study Group. JAMA. 1995 Jul 5;274(1):35–43. [PubMed]
  • Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, Small SD, Sweitzer BJ, Leape LL. The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997 Jan 22;277(4):307–311. [PubMed]
  • Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1997 Jan 22;277(4):301–306. [PubMed]
  • Bates DW, Leape LL, Petrycki S. Incidence and preventability of adverse drug events in hospitalized adults. J Gen Intern Med. 1993 Jun;8(6):289–294. [PubMed]
  • Bates DW, Boyle DL, Vander Vliet MB, Schneider J, Leape L. Relationship between medication errors and adverse drug events. J Gen Intern Med. 1995 Apr;10(4):199–205. [PubMed]
  • Kaushal R, Bates DW, Landrigan C, McKenna KJ, Clapp MD, Federico F, Goldmann DA. Medication errors and adverse drug events in pediatric inpatients. JAMA. 2001 Apr 25;285(16):2114–2120. [PubMed]
  • Kellaway GS, McCrae E. Intensive monitoring for adverse drug effects in patients discharged from acute medical wards. N Z Med J. 1973 Dec 26;78(505):525–528. [PubMed]
  • Hutchinson TA, Flegel KM, Kramer MS, Leduc DG, Kong HH. Frequency, severity and risk factors for adverse drug reactions in adult out-patients: a prospective study. J Chronic Dis. 1986;39(7):533–542. [PubMed]
  • Sciamanna CN, Hoch JS, Duke GC, Fogle MN, Ford DE. Comparison of five measures of motivation to quit smoking among a sample of hospitalized smokers. J Gen Intern Med. 2000 Jan;15(1):16–23. [PMC free article] [PubMed]
  • Leape LL. Error in medicine. JAMA. 1994 Dec 21;272(23):1851–1857. [PubMed]
  • Berwick DM. Continuous improvement as an ideal in health care. N Engl J Med. 1989 Jan 5;320(1):53–56. [PubMed]
  • Glauber J, Goldmann DA, Homer CJ, Berwick DM. Reducing medical error through systems improvement: the management of febrile infants. Pediatrics. 2000 Jun;105(6):1330–1332. [PubMed]
  • Leape LL, Cullen DJ, Clapp MD, Burdick E, Demonaco HJ, Erickson JI, Bates DW. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999 Jul 21;282(3):267–270. [PubMed]
  • Bates DW, Teich JM, Lee J, Seger D, Kuperman GJ, Ma'Luf N, Boyle D, Leape L. The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc. 1999 Jul-Aug;6(4):313–321. [PMC free article] [PubMed]
  • Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM, Burdick E, Hickey M, Kleefield S, Shea B, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998 Oct 21;280(15):1311–1316. [PubMed]
  • Teich JM, Merchia PR, Schmiz JL, Kuperman GJ, Spurr CD, Bates DW. Effects of computerized physician order entry on prescribing practices. Arch Intern Med. 2000 Oct 9;160(18):2741–2747. [PubMed]
  • Chertow GM, Lee J, Kuperman GJ, Burdick E, Horsky J, Seger DL, Lee R, Mekala A, Song J, Komaroff AL, et al. Guided medication dosing for inpatients with renal insufficiency. JAMA. 2001 Dec 12;286(22):2839–2844. [PubMed]
  • Overhage JM, Tierney WM, Zhou XH, McDonald CJ. A randomized trial of "corollary orders" to prevent errors of omission. J Am Med Inform Assoc. 1997 Sep-Oct;4(5):364–375. [PMC free article] [PubMed]
  • Evans RS, Classen DC, Pestotnik SL, Lundsgaarde HP, Burke JP. Improving empiric antibiotic selection using computer decision support. Arch Intern Med. 1994 Apr 25;154(8):878–884. [PubMed]
  • Evans RS, Pestotnik SL, Classen DC, Clemmer TP, Weaver LK, Orme JF, Jr, Lloyd JF, Burke JP. A computer-assisted management program for antibiotics and other antiinfective agents. N Engl J Med. 1998 Jan 22;338(4):232–238. [PubMed]
  • Burton ME, Ash CL, Hill DP, Jr, Handy T, Shepherd MD, Vasko MR. A controlled trial of the cost benefit of computerized bayesian aminoglycoside administration. Clin Pharmacol Ther. 1991 Jun;49(6):685–694. [PubMed]
  • Casner PR, Reilly R, Ho H. A randomized controlled trial of computerized pharmacokinetic theophylline dosing versus empiric physician dosing. Clin Pharmacol Ther. 1993 Jun;53(6):684–690. [PubMed]
  • Hurley SF, Dziukas LJ, McNeil JJ, Brignell MJ. A randomized controlled clinical trial of pharmacokinetic theophylline dosing. Am Rev Respir Dis. 1986 Dec;134(6):1219–1224. [PubMed]
  • Mungall DR, Anbe D, Forrester PL, Luoma T, Genovese R, Mahan J, LeBlanc S, Penney JB. A prospective randomized comparison of the accuracy of computer-assisted versus GUSTO nomogram--directed heparin therapy. Clin Pharmacol Ther. 1994 May;55(5):591–596. [PubMed]
  • White RH, Hong R, Venook AP, Daschbach MM, Murray W, Mungall DR, Coleman RW. Initiation of warfarin therapy: comparison of physician dosing with computer-assisted dosing. J Gen Intern Med. 1987 May-Jun;2(3):141–148. [PubMed]
  • Barker KN. The effects of an experimental medication system on medication errors and costs. I. Introduction and errors study. Am J Hosp Pharm. 1969 Jun;26(6):324–333. [PubMed]
  • Barker KN, Pearson RE, Hepler CD, Smith WE, Pappas CA. Effect of an automated bedside dispensing machine on medication errors. Am J Hosp Pharm. 1984 Jul;41(7):1352–1358. [PubMed]
  • Barker KN, Allan EL. Research on drug-use-system errors. Am J Health Syst Pharm. 1995 Feb 15;52(4):400–403. [PubMed]
  • Chester MI, Zilz DA. Effects of bar coding on a pharmacy stock replenishment system. Am J Hosp Pharm. 1989 Jul;46(7):1380–1385. [PubMed]
  • Meyer GE, Brandell R, Smith JE, Milewski FJ, Jr, Brucker P, Jr, Coniglio M. Use of bar codes in inpatient drug distribution. Am J Hosp Pharm. 1991 May;48(5):953–966. [PubMed]
  • Koren G, Barzilay Z, Greenwald M. Tenfold errors in administration of drug doses: a neglected iatrogenic disease in pediatrics. Pediatrics. 1986 Jun;77(6):848–849. [PubMed]
  • Kuperman GJ, Sussman A, Schneider LI, Fiskio JM, Bates DW. Towards improving the accuracy of the clinical database: allowing outpatients to review their computerized data. Proc AMIA Symp. 1998:220–224. [PMC free article] [PubMed]
  • Ash JS, Gorman PN, Hersh WR. Physician order entry in U.S. hospitals. Proc AMIA Symp. 1998:235–239. [PMC free article] [PubMed]
  • Ringold DJ, Santell JP, Schneider PJ. ASHP national survey of pharmacy practice in acute care settings: dispensing and administration--1999. Am J Health Syst Pharm. 2000 Oct 1;57(19):1759–1775. [PubMed]
  • Milstein A, Galvin RS, Delbanco SF, Salber P, Buck CR., Jr Improving the safety of health care: the leapfrog initiative. Eff Clin Pract. 2000 Nov-Dec;3(6):313–316. [PubMed]
  • Dean B. Learning from prescribing errors. Qual Saf Health Care. 2002 Sep;11(3):258–260. [PMC free article] [PubMed]

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