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Effect of EHR user interface changes on internal prescription discrepancies.
A Turchin1, A Sawarkar2, Y A Dementieva3
1Harvard Clinical Research Institute , Boston, MA ; Division of Endocrinology, Brigham and Women's Hospital , Boston, MA ; Harvard Medical School , Boston, MA.
Applied Clinical Informatics
|October 10, 2014
Summary
User interface changes in electronic health record medication modules can reduce prescription errors. Specific design interventions decreased internal prescription discrepancies, improving medication safety.
Area of Science:
- Health Informatics
- Medical Error Reduction
- Electronic Health Records (EHRs)
Background:
- Internal prescription discrepancies, contradictions between structured and narrative data in electronic prescriptions, pose a risk to patient safety.
- Electronic health records (EHRs) are widely used, but their medication modules can contain design flaws leading to errors.
Purpose of the Study:
- To evaluate the impact of specific user interface (UI) design changes within an EHR medication module on the incidence of internal prescription discrepancies.
Main Methods:
- A retrospective analysis of 960,000 electronic prescriptions from 2004-2011 was conducted.
- A natural language processing tool identified discrepancies, and an ARIMA model assessed the effect of five UI interventions.
Main Results:
- 18.4% of prescriptions had internal discrepancies during the study period.
- Adding an "as directed" option reduced discrepancies by 195/month (p=0.0004).
- A non-interruptive alert reduced discrepancies by 145/month (p=0.03).
Conclusions:
- Specific UI modifications in EHR medication modules can significantly decrease internal prescription discrepancies.
- Further research is needed to develop interventions that eliminate these errors and improve patient outcomes.
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