Identifying Causes of Electronic Prescription Error: is the Software or Physician at Fault?

Abstract

Specific Aims: The purpose of this study was to investigate areas of ambiguity or error in the content of prescriptions generated using DrFirst’s electronic prescribing software Rcopia adetermines whether these quality issues are attributed to the software, physician, or both. Methods: Electronic prescriptions generated by DrFirst electronic prescribing software, Rcopia, from July 2012 through September 2012 were analyzed regarding the following metrics: number of free text prescriptions, quantity unit mismatches, and SIG issues. These metrics were expressed as a percentage of the total number of prescriptions generated for each month and used for descriptive analysis. Main Results: The total number of prescriptions generated were 12,043,268, of which 363,142 (3%) were free text (uncoded) and 11,680,126 (97%) were non-free text. SIG as directed was identified in 227,732 prescriptions, of which 11,208 (3.1%) were free text and 216,524(1.9%) were non-free text. Double SIG was identified in 174,625 prescriptions, of which 75,336 (20.1%) were free text and 1,746,250 (14.1%) were non-free text. A total of 830 (0.23%) of free text prescriptions contained a Latin abbreviation. Of 621,816 prescriptions containing a quantity unit error, 7,684 (2.1%) were free text prescriptions and 614,132 (5.3%) were non-free text prescriptions. Conclusion: The authors concluded that the software and physician are responsible for error. There were errors associated with selections made by the prescriber in the drop down menus and coded medications in Rcopia. Furthermore, errors were found in free text prescriptions which must be manually entered by the physician or their staff.