Comparison of a Prototype for Indications-Based Prescribing With 2 Commercial Prescribing Systems.

Area of Science:

• Health Informatics
• Clinical Decision Support
• Medical Error Reduction

Background:

• Medication indications are often omitted from prescriptions due to limitations in current electronic prescribing systems.
• This omission hinders effective medication management and patient safety.

Purpose of the Study:

• To assess the efficiency, error rates, and user satisfaction of a novel computerized provider order entry (CPOE) prototype designed to incorporate medication indications.
• To compare this prototype against the prescribing modules of two leading electronic health record (EHR) systems.

Main Methods:

• A quality improvement study involving 32 internal medicine physicians, residents, and physician assistants.
• Usability testing with 8 clinical scenarios, randomizing participants to use the prototype or their usual EHR system for half the scenarios.
• Data collected included time on task, number of clicks, order details, and user satisfaction via validated scales.

Main Results:

• The prototype significantly reduced time on task (1.78 minutes) compared to EHR vendor 1 (3.37 minutes) and vendor 2 (2.93 minutes).
• Fewer clicks were required with the prototype (18.39-20.10) versus EHR systems (46.50 and 38.25).
• Medication errors were substantially lower with the prototype (7/128 sessions) compared to vendor systems (38/128 sessions).

Conclusions:

• Reengineering the prescribing process to initiate with the drug indication improves usability and efficiency.
• This approach may lead to reduced medication errors and increased clinician satisfaction.
• The findings support the integration of indication-based prescribing into routine clinical practice.