Appl Clin Inform 2016; 07(02): 587-595
DOI: 10.4338/ACI-2015-10-RA-0140
Research Article
Schattauer GmbH

Optimized Computerized Order Entry can Reduce Errors in Electronic Prescriptions and Associated Pharmacy Calls to Clarify (CTC)

Jaimin Patel
1  University of Mississippi, Neonatology, Department of Information systems., Jackson, Mississippi, United States
,
Richard Ogletree
2  University of Mississippi Medical Center, Pharmacy, Jackson, Mississippi, United States
,
Allison Sutterfield
1  University of Mississippi, Neonatology, Department of Information systems., Jackson, Mississippi, United States
,
John C. Pace
1  University of Mississippi, Neonatology, Department of Information systems., Jackson, Mississippi, United States
,
Laurene Lahr
1  University of Mississippi, Neonatology, Department of Information systems., Jackson, Mississippi, United States
› Author Affiliations
Further Information

Correspondence to:

Jaimin Patel
Assistant Prof. Pediatric
Assistant CMIO
University of Mississippi
Neonatology Division
W112, 2500 N. State St
Jckson, MS 39110

Publication History

received: 16 October 2015

accepted: 18 April 2016

Publication Date:
16 December 2017 (online)

 

Summary

Background

After implementation of a system-wide EMR within our university system, e-prescribing is now commonplace.

Objective

The authors conducted a study to assess whether optimization of computerized provider order entry (CPOE) can reduce errors in these electronically transmitted prescriptions and would require less frequent interventions from pharmacists, in particular the need for them to “call to clarify” (CTC) details of particular prescriptions. Secondary analysis based on cost assumptions was preformed to presume cost differences before and after optimization changes.

Materials and Methods

In order to generate complete, error-free prescriptions, optimization changes were implemented in the form of in line validation messages. These messages were generated if (1) an order did not specify a provider or pharmacy; (2) the DEA requirements were not met; (3) character limits were exceeded in patient sig or demographics or (4) administration instructions had breaks or had both discrete and free text elements. Retrospectively, prescriptions were randomly selected from a nine month period before and after implementing changes. These prescriptions were analyzed by a pharmacist and a nurse to identify types of errors that would require a CTC to a prescribing provider. Errors were compared statistically to determine effectiveness of changes pre and post optimization.

Results

A total of 602 prescriptions were analyzed; 301 before changes and 301 after changes. Of these prescriptions, 20.27% had errors before changes and 12.96% had errors after changes. The decline in the error rate was considered statistically significant for p<0.05. The cost savings were estimated at $76 per 100 prescriptions for pharmacist and physician time-cost estimates combined.

Conclusions

Implementing optimization changes to the CPOE resulted in a reduction in error rate requiring pharmacist CTC. This study identifies effective optimization changes for electronic prescribing that can reduce prescribing errors and may result in cost saving.


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Conflict of Interest

The authors declare that they have no conflicts of interest in the research.


Correspondence to:

Jaimin Patel
Assistant Prof. Pediatric
Assistant CMIO
University of Mississippi
Neonatology Division
W112, 2500 N. State St
Jckson, MS 39110