Owing to the rapid adoption of certified EHRs (Electronic Health Records) and Health IT (Health Information Technology) tools, the ONC (Office of the National Coordinator for Health Information Technology) has been very concerned about the safe use of these tools. A slight human error such as a wrong selection of an option in a drop-down menu can cause a big problem to the patients. It can alter their medical record and even cause the wrong medication to be prescribed to them.
Committed to utilizing its efforts of providing safer Health IT solutions to the masses, an ONC contractor, RTI International, organized a workgroup of clinical care and health IT experts to address medication management errors in ambulatory EHR systems. The study published a report titled ‘Issues and Recommended Solutions for Improved Usability in Patient Selection and Medication Ordering’ which offered numerous ways to help chief medical information officers (CMIOs), implementers, health IT developers and patient care teams in minimizing the risk of pick list errors and help detection of errors before patients are harmed.
Pick list errors can occur during several tasks in the medication management process but the report was found to be focussing on two error types:
- Wrong-Patient Error: Errors that occur when wrong patient’s record is being used.
- Wrong-Medication Error: Errors that occur when the wrong medication is selected from a drop-down list.
The report also identified six available and beneficial straightforward measures that were not presently being used by many establishments in their processes for ordering medications using an EHR but can be used to decrease the risk of each error. They are as follows:
- Using specific design features purposely crafted to reduce wrong-patient pick list errors (for example using patients’ photographs in the record
- Standardizing the names of drugs listed in the EHR
- Implementing the best practices of organizing, designing, and configuring pick lists, including standardized drugs being prescribed through the EHR;
- Developing a summary review screen which could be viewed before a medication order is finalized
- Making correcting or revising incorrect orders easier for clinicians
- Providing all patients with lists of their current medications along with information on why each medication is prescribed to them.
The above-mentioned recommendations and resources were developed focusing on ambulatory care settings, such as doctors’ offices or small to medium sized practices. They are also appropriate for consideration in hospitals and long-term care facilities.
