The safety and effectiveness of hospital e-prescribing systems: a controlled time series study

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Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are believed to significantly reduce the number of errors which occur and reduce harm to patients as a result. No studies have demonstrated that these systems result in reducing prescribing errors that cause harm to patients. Alarmingly, anecdotal evidence from overseas suggests that use of electronic prescribing systems introduces new types of errors. This is consistent with a growing body of scientific research which suggests that individuals' decision-making may be significantly influenced by information generated by a computer, resulting in new types of errors. The aim of this project is to undertake a controlled time series study to assess the safety and effectiveness of two electronic prescribing systems to reduce prescribing errors in Australian hospitals. The study will compare error rates before and after the introduction of the systems. In addition, the study will be the first to focus on measuring new types of errors that may result from system use and to investigate how computer use influences clinicians' decision-making. This study will provide critical information about the effectiveness and safety of these systems which are being introduced into Australian hospitals. Unlike other medical interventions, which require stringent safety testing before use with patients, there are no minimum safety requirements for electronic prescribing systems. The data from this study is urgent in developing recommendations to ensure the safety of electronic prescribing systems for Australia.