JMIR Publications

ABSTRACT

Background:

Medication errors represent a significant source of patient harm, contributing to unnecessary healthcare costs and serving as a potentially preventable cause of medical mistakes. In the past decade, numerous hospitals have implemented various computerized provider order entry (CPOE) systems and automatic technology in pharmacy. However, there is limited real-world data demonstrating the changes in clinical prescription error rates following the adoption of these advanced information systems.

Objective:

The objective of this study is to detect and prospectively record the categories and rates of medication errors during the period of January 2017 to December 2023, as well as to illustrate how medication-related technologies can be utilized to reduce the incidence of medication errors.

Methods:

The study was conducted in a 2,111-bed care academic medical center located in central Taiwan. The period spanned from January 1, 2017, to December 31, 2023. All medication errors detected and prevented by pharmacists during periods, as well as any improvements in the information technology system (IT system) categories and implementation times, were systematically recorded and analyzed.

Results:

In summary, the implementation of Barcode Medication Administration (BCMA), Automated Dispensing Cabinets (ADC), and Smart Dispensing Counters (SDC) in the pharmacy setting demonstrated significant reductions in medication errors. The study, spanning seven years, revealed a notable decrease in the rate of reported medication errors each month after the introduction of these technologies. The severity breakdown indicated a predominant occurrence of "near miss" incidents, emphasizing the potential harm reduction associated with the implemented systems. Incident types, particularly errors related to wrong medication and wrong quantity, showed substantial improvements. The quantitative research, utilizing the Power BI (business intelligence) program for visual data analytics, highlighted a consistent decline in medication error incidence rates over time. Furthermore, the qualitative phase emphasized the positive impact of BCMA, SDC, and ADC on workflow efficiency, prescription dispensing accuracy, and overall patient safety. The results underscore the importance of post-implementation resources, education, and training to address system-related errors and maximize the benefits of these technologies in healthcare settings.

Conclusions:

The study results highlight the significant risk to patients from medication prescribing errors. Over the 7 years research period, it was demonstrated that implementing IT to improve the CPOE system and clinical decision support systems can promote quality pharmaceutical services directed at appropriate medication therapy.