The impact of computerized prescribing on error rate in a department of Oncology/Hematology

A comparison of prescribing errors detected for computerized and spreadsheet prescriptions in the Department of Hematology and Oncology of the Norfolk and Norwich University hospital.

A prospective audit of 1941 prescriptions for chemotherapy was made from January to September 2005. Each new cycle of chemotherapy ordered was monitored for prescribing errors, which were analyzed by method of prescription (computerized or spreadsheet), prescriber, type, and severity.

Computerized prescribing reduced errors by 42% (RR 0.58; 95% CI 0.47-0.72). Errors occurred in 20% of spreadsheet prescriptions compared with 12% of the computerized prescriptions. There was a significant difference in error rates of three different prescribers whichever prescribing system was used. The proportion of errors that were minor was reduced and serious was increased with little change in the proportion of significant or life-threatening errors.

The impact of computerized prescribing on adverse drug events requires further evaluation. Prescriber training may be important in further reducing errors. The implementation of all the existing functions of the electronic system should lead to further reduction in errors.