Identifying Electronic Medication Administration Record (eMAR) Usability Issues from Patient Safety Event Reports

Area of Science:

• Health Informatics
• Patient Safety
• Human-Computer Interaction

Background:

• Medication errors are a significant concern in healthcare.
• Health information technology (health IT) usability is increasingly recognized as a factor in patient safety.
• Understanding the link between health IT usability and medication errors is vital for error reduction.

Purpose of the Study:

• To investigate the contribution of electronic medication administration record (eMAR) usability challenges to medication errors.
• To analyze patient safety event reports (PSEs) to identify specific eMAR-related usability issues.
• To provide evidence-based recommendations for improving eMAR technology and patient safety.

Main Methods:

• Analysis of 849 free-text descriptions from medication-related patient safety event reports (PSEs).
• Identification of health IT components, usability challenge categories, and themes contributing to PSEs.
• Thematic analysis to refine categorizations and identify emerging themes, focusing on eMAR's role in errors.

Main Results:

• The electronic medication administration record (eMAR) contributed to 473 PSEs.
• eMAR was the origin of 17.8% of these errors, with workflow support and display/visual clutter as key challenges.
• In 82.2% of cases, eMAR contributed downstream, primarily due to issues with Pharmacy IT and computerized provider order entry (CPOE), with display/visual clutter being a prominent secondary challenge.

Conclusions:

• Specific eMAR usability challenges significantly contribute to medication errors.
• Improving the eMAR user interface is critical for patient safety.
• Recommendations include enhanced interface design, vendor and facility usability testing, and consideration of work system factors.