Electronic Medication Systems Research Articles

The Health Innovation Series: Translating Research Evidence into Practice.

Electronic medication systems (EMS) improve medication safety in hospitals; however require modifications to optimize their performance. Drawing on a five-year program of research, we developed the Health Innovation Series to disseminate recommendations arising from our research to a wide audience. Each issue contains EMS optimization tips that can be actioned by EMS managers and system vendors, as well as user tips for health professionals including nurses, doctors and pharmacists. Five issues were released by 30 Nov 2022, via two email campaigns, with further issues planned. The five issues had 2,035 downloads by March 2023. The most recent email campaign open and click rates indicate very good audience engagement.

The Economics of Medication Safety: A Cost-Benefits Analysis Framework for Evaluating an Electronic Medication System.

Medication prescribing in paediatrics is complex and compounded by the need to provide age and weight related doses, and errors continue to be problematic. Electronic medication systems (EMS) can reduce errors through dosing calculators and computerised decision support. However, evidence on costs and benefits of these systems is limited, particularly in paediatric hospitals. This paper presents the development of a cost-benefit analysis (CBA) framework to assess the impact of an EMS implementation in a paediatric tertiary hospital. An innovative component of the framework is the incorporation of the impact of the effects of the EMS for both the health system as well as for patients and their wider family networks, allowing a net social benefit assessment. We describe the impact of non-clinical out-of-pocket costs of admission and use discrete choice experiments to measure both medication related harm and the importance of medication safety to families and members of the community.

Evaluation of Medication Error Reports Sent to Food and Drug Deputy From Hospitals Affiliated to Mazandaran University of Medical Sciences, Mazandaran Province, Iran, 2015-2018

Background: Medical errors are one of the most common threats to patient safety. Medication errors have several consequences, including the increase in patients’ mortality, length of stay, and healthcare costs.
 Objectives: This study was conducted in Food and Drug Deputy of Mazandaran University of Medical Sciences (MAZUMS) to evaluate medication errors.
 Methods: This study was conducted by the Food and Drug Deputy of Mazandaran University on medication errors reported and received from affiliated hospitals during 2015-2018. The analysis was performed based on the cause of the error, the frequency of the drugs, routs of administration, and the type.
 Results: Out of 3033 reported cases, the results of data analysis indicated that the highest percentage of these errors was related to antibiotics (22.84%). According to the results, the most common type of error belonged to the incorrect drug (44.18%), incorrect dose (25.65%), and drug omission (16.68%). The most common cause of the errors was related to neglect and insufficient care by the medical team (38.24%) and no or incorrect mention of the details of prescribed medications (in Kardex, HIS, etc.) by nurses (14.96%).
 Conclusion: Regular in-hospital training for medical staff focused on teaching the standards required for the administration and use of various medications, and identification of common medication errors can prepare guidelines to reduce these errors in hospitals. Besides, providing measures such as electronic prescription and medication systems based on a unit-dose drug distribution system can also help reduce medication errors.

How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis.

ObjectiveTo conduct a systematic review and meta-analysis to assess: 1) changes in medication error rates and associated patient harm following electronic medication system (EMS) implementation; and 2) evidence of system-related medication errors facilitated by the use of an EMS.Materials and MethodsWe searched Medline, Scopus, Embase, and CINAHL for studies published between January 2005 and March 2019, comparing medication errors rates with or without assessments of related harm (actual or potential) before and after EMS implementation. EMS was defined as a computer-based system enabling the prescribing, supply, and/or administration of medicines. Study quality was assessed.ResultsThere was substantial heterogeneity in outcomes of the 18 included studies. Only 2 were strong quality. Meta-analysis of 5 studies reporting change in actual harm post-EMS showed no reduced risk (RR: 1.22, 95% CI: 0.18–8.38, P = .8) and meta-analysis of 3 studies reporting change in administration errors found a significant reduction in error rates (RR: 0.77, 95% CI: 0.72–0.83, P = .004). Of 10 studies of prescribing error rates, 9 reported a reduction but variable denominators precluded meta-analysis. Twelve studies provided specific examples of system-related medication errors; 5 quantified their occurrence.Discussion and ConclusionDespite the wide-scale adoption of EMS in hospitals around the world, the quality of evidence about their effectiveness in medication error and associated harm reduction is variable. Some confidence can be placed in the ability of systems to reduce prescribing error rates. However, much is still unknown about mechanisms which may be most effective in improving medication safety and design features which facilitate new error risks.

Changes in medication administration error rates associated with the introduction of electronic medication systems in hospitals: a multisite controlled before and after study

BackgroundElectronic medication systems (EMS) have been highly effective in reducing prescribing errors, but little research has investigated their effects on medication administration errors (MAEs).ObjectiveTo assess changes in MAE rates and...

Electronic medication systems risk patient safety if not implemented properly, safety body warns

Electronic medication systems risk patient safety if not implemented properly, safety body warns

Electronic patient record as the tool for better patient safety

Recent studies indicate again that there is a deficit in the use of electronic health records (EHR) in German hospitals. Despite good arguments in favour of their use, such as the rapid availability of data, German hospitals shy away from a wider implementation. The reason is the high cost of installing and maintaining the EHRs, for the benefit is difficult to evaluate in monetary terms for the hospital. Even if a benefit can be shown it is not necessarily evident within the hospital, but manifests itself only in the health system outside. Many hospitals only manage to partly implement EHR resulting in increased documentation requirements which reverse their positive effect.In the United States, electronic medical records are also viewed in light of their positive impact on patient safety. In particular, electronic medication systems prove the benefits they can provide in the context of patient safety. As a result, financing systems have been created to promote the digitalisation of hospitals in the United States. This has led to a large increase in the use of IT systems in the United States in recent years. The Universitätsklinikum Eppendorf (UKE) introduced electronic patient records in 2009. The benefits, in particular as regards patient safety, are numerous and there are many examples to illustrate this position. These positive results are intended to demonstrate the important role EHR play in hospitals. A financing system of the ailing IT landscape based on the American model is urgently needed to benefit-especially in terms of patient safety-from electronic medical records in the hospital.

Linked electronic medication systems in community pharmacies for preventing pseudoephedrine diversion: A review of international practice and analysis of results in Australia

Pseudoephedrine is a precursor often diverted into the illegal manufacture of amphetamine type substances (ATS). The aim of this study was to evaluate the effectiveness of a linked electronic medication recording system (LEMS) established in Australian pharmacies in 2005 for preventing the diversion of pseudoephedrine. The number of illegal ATS laboratories detected in each jurisdiction of Australia from 1996-1997 to 2004-2005 were analysed by linear regression nationally and by each jurisdiction. The statistical significance of seizures in 2005-2006 was based on the comparison of the observed value to the 95% prediction confidence intervals calculated from the historical data for each jurisdiction and nationally. Pharmacies in Queensland commenced an LEMS in late 2005 to minimise retail pseudoephedrine diversion. The number of ATS laboratories seized in 2005-2006 in Queensland was significantly lower (P < 0.05) than predicted by historical data. For all other jurisdictions and nationally the totals of laboratories seized in 2005-2006 were not significantly different from predicted values. The significant decline in ATS illegal laboratories seized in Queensland in 2005-2006 suggests the effective use of LEMS in pharmacies to minimise pseudoephedrine diversion. In order to evaluate a national LEMS, more frequent data on numbers of linked pharmacies, ATS laboratories seized and indicators of pseudoephedrine sales and misuse are required. Testing the use of LEMS by pharmacies for preventing the diversion of other medicines seems appropriate.