Gildon Brooke L, Condren Michelle, Hughes Christine C
College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK 73096, USA.
School of Community Medicine, University of Oklahoma, Tulsa, OK 74135, USA.
Healthcare (Basel). 2019 Apr 5;7(2):57. doi: 10.3390/healthcare7020057.
Medication errors are commonly reported in the pediatric population. While evidence supports the use of e-prescribing to prevent certain errors, prescribing with an electronic health record (EHR) system is not devoid of errors. Furthermore, the majority of EHRs are not equipped with functionalities addressing pediatric needs. This study analyzes three unique EHRs in three pediatric clinics. It describes the functionality of each system and identifies errors found in e-prescribed prescriptions. Finally, the study estimates the proportion of e-prescribing errors that could have been avoided if those EHRs had met requirements set by the American Academy of Pediatrics (AAP). The number of prescriptions reviewed for Clinics 1, 2, and 3, respectively, were: 477, 408, and 633 with total error rates of 13.2%, 8.8%, and 6.6%. The clinic EHRs included 21%, 26%, and 47% of the AAP pediatric requirements for safe and effective e-prescribing for children. If all AAP elements had been included in the EHRs, over 83% of errors in the examined e-prescriptions could have been prevented. This study demonstrates that EHR systems used by many pediatric clinic practices do not meet the standard set forth by the AAP. To ensure our most vulnerable population is better protected, it is imperative that medical technology tools adequately consider pediatric needs during development and that this is reflected in selected EHR systems.
用药错误在儿科人群中屡有报道。虽然有证据支持使用电子处方来预防某些错误，但使用电子健康记录（EHR）系统开处方并非没有错误。此外，大多数电子健康记录系统并未配备满足儿科需求的功能。本研究分析了三家儿科诊所使用的三种独特的电子健康记录系统。它描述了每个系统的功能，并识别了电子处方中发现的错误。最后，该研究估计了如果这些电子健康记录系统符合美国儿科学会（AAP）设定的要求，原本可以避免的电子处方错误的比例。诊所1、2和3分别审查的处方数量为：477份、408份和633份，总错误率分别为13.2%、8.8%和6.6%。这些诊所的电子健康记录系统分别包含了美国儿科学会关于儿童安全有效电子处方要求的21%、26%和47%。如果电子健康记录系统包含了美国儿科学会的所有要素，那么在所审查的电子处方中，超过83%的错误本可避免。这项研究表明，许多儿科诊所使用的电子健康记录系统未达到美国儿科学会所设定的标准。为确保我们最脆弱的人群得到更好的保护，至关重要的是，医疗技术工具在开发过程中要充分考虑儿科需求，并在所选的电子健康记录系统中得以体现。
