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Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing

G D Schiff1, M G Amato2, T Eguale3

  • 1Brigham and Women's Hospital Division of General Medicine and Primary Care, Boston, Massachusetts, USA Harvard School of Medicine, Boston, Massachusetts, USA.

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PubMed
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Computerised provider order entry (CPOE) systems can introduce medication errors. Analysis of error reports revealed significant vulnerabilities in current CPOE systems, highlighting the need for enhanced safety measures.

Keywords:
Decision support, computerizedHuman errorInformation technologyMedication safetyPatient safety

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Area of Science:

  • Health Informatics
  • Patient Safety
  • Medical Error Analysis

Background:

  • Computerised provider order entry (CPOE) is widely adopted to reduce medication errors.
  • However, CPOE systems can also be a source of new or contributing medication errors.

Purpose of the Study:

  • To analyze medication error reports where CPOE was a contributing factor.
  • To develop use cases from these reports to test CPOE system vulnerabilities.

Main Methods:

  • Reviewed 10,060 CPOE-related medication errors from the MEDMARX system (2003-2010).
  • Developed a taxonomy of CPOE errors, reasons, prevention strategies, and recurring scenarios.
  • Tested the vulnerability of 13 leading CPOE systems using these error scenarios.

Main Results:

  • Over 63,000 CPOE-related errors were reported.
  • Identified 101 error types, 67 reasons, 73 prevention strategies, and 21 error scenarios.
  • 79.5% of erroneous orders could be entered into CPOE systems, with 28% entered easily.

Conclusions:

  • Medication error reports are crucial for understanding CPOE-related errors.
  • Current CPOE systems exhibit vulnerabilities to recurring error scenarios.
  • Enhanced monitoring, reporting, and testing are vital for improving CPOE safety.