Drop-down menus may be to blame for e-prescribing errors

Fewer drop down menus in e-prescribing systems could reduce common errors, according to a new study in the Journal of the American Medical Informatics Association.

The researchers tracked 629 inpatient admissions at two hospitals in Sydney and the use of two e-prescribing systems: CSC MedChart and Cerner Millennium e-PS. 

They looked at system errors made by selecting items from drop-down menus, constructing orders, editing orders or failing to complete new e-PS tasks. Both systems prevented significantly more errors than they generated, the researchers said.

Overall, 42.4 percent of 1,164 prescribing errors were system-related, while only 2.2 percent were serious errors. 

There was little difference in number of errors between the two systems, with one exception: drug-strength errors were 13 times more common with the MedChart System. In the Cerner system, editing errors most frequently ordered the wrong route or wrong formulation.  

With the bulk of systems errors caused by the need to select from a drop-down menu or edit information within the system, staff have to be that much more vigilant that information in the orders is correct, the authors said, and better design could help eliminate some of these errors. 

Sixty-nine percent of U.S. physicians used e-precribing in 2012, according to Surescripts' recently released annual National Progress Report and Safe-Rx Rankings.

The Safety Assurance Factors for Electronic Health Record Resilience study protocol, also known as the "SAFER project," cited e-prescribing among nine high risk areas related to EHRs slated for scrutiny.

Meanwhile, a previous JAMIA article pointed out another issue with e-prescribing: drug alerts that overwhelm doctors with information or appear too late in the prescribing process.

To learn more:
- read the research

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