Computers reduce medication errors

Advanced technology in the health care industry is reducing the rate of incidence of serious medication errors, according to findings recently presented at the "Enhancing Patient Safety and Reducing Errors in Health Care" conference hosted by the American Association for the Advancement of Science in Rancho Mirage, CA.

Researchers cited examples of potentially serious adverse effects being avoided thanks to the introduction of computers to health care delivery and prescription-fulfillment processes.

For example, replacing hand-written medication orders with a computerized physician order entry system reduced serious medication errors by 86% at Brigham Women's Hospital in Boston. And Kenneth Kizer, M.D., under secretary for the U.S. Department of Veterans' Affairs, announced that the Veterans Health Administration will use computers to order and track all medications within its 173 hospitals next year because of proven results that they make patient care safer.

Introducing a medication bar coding pilot project featuring an automated wireless system that verified identity in a VHA hospital in Topeka, KS, "demonstrated dramatic improvements" in delivering safe patient care, Kizer said.

At Barnes-Jewish Hospital in St. Louis, a new computerized system that scans for potentially dangerous drug combinations reduced 66% of potentially unsafe combinations with the gastrointestinal drug cisapride. And researchers at the University of Toronto reported that reconfiguring a machine used by patients to self-administer their pain medications eliminated 55% of programming mistakes made by hospital staff.

Researchers at the conference proposed developing and utilizing a computer program that predicts error potential by scanning medication names that sound or look alike.

Value of common sense

However, sometimes computers are only as smart as the people who use them.

At the Cleveland Clinic Foundation, 15% of minor errors that were not eliminated after administrators introduced computerized radiation therapy equipment were due solely to lapses in human judgment. Some human operators trusted the computer safety system's accuracy more than they trusted their own common sense, and researchers reported that some of the errors might have been caught earlier had they been annotated on hand-written data entry forms.

At Massachusetts General Hospital, placing a clinical pharmacist on an intensive care unit patient care team reduced preventable adverse drug events by 77%. And standardizing medication orders, eliminating "look-alike" medications and revamping processes led to a 50% reduction in errors at Hermann Hospital in Houston.

Donald Berwick, president of the Institute for Health Care Improvement and a keynote speaker at the conference, called for more simplification and greater standardization in medication delivery, such as the introduction of bar codes, to help people use computers to further reduce the incidence of medication error. PR