Electronic Medication Management Systems: Analysis of Enhancements to Reduce Errors and Improve Workflow

Area of Science:

• Health Informatics
• Patient Safety
• Clinical Pharmacy

Background:

• Electronic medication management (eMM) systems reduce medication errors but introduce new safety risks.
• Previous research has not systematically examined eMM system updates designed to mitigate these emergent risks.

Purpose of the Study:

• To identify system-related medication errors or workflow disruptions addressed by eMM system updates.
• To characterize the types of medications involved in these updates.
• To describe and classify the system enhancements implemented to mitigate identified risks.

Main Methods:

• Retrospective qualitative study analyzing documents of eMM system updates from November 2014 to December 2019.
• Medication-related updates were classified based on the rationale for change and the specific system modifications.

Main Results:

• 117 updates comprising 147 individual changes were made over the 4-year period.
• Primary reasons for updates included preventing medication errors (24%), optimizing workflow (22%), and aligning with paper-based practices (16%).
• Common modifications involved adding list options (14%), enhancing on-screen information (8%), and altering text phrasing (8%); 37% of updates concerned high-risk medications.

Conclusions:

• This is the first systematic review categorizing eMM system updates for safety risk mitigation.
• eMM optimization is an evolving process influenced by user familiarity and expanded system use.
• Continuous system monitoring is crucial for ongoing improvement and maximizing the benefits of electronic medication management.