Klein Stephanie, Tsanas Athanasios, Coleman Jamie, Osselton Rebecca, Heed Jude, Slee Ann, Watson Neil
Pharmacy Department, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, England, UK.
Usher Institute, University of Edinburgh, Edinburgh, EH16 4UX, Scotland, UK.
Sci Rep. 2025 Jan 16;15(1):2120. doi: 10.1038/s41598-025-86112-w.
Prescribing errors are a source of preventable harm in healthcare, which may be mitigated using Electronic Prescribing (EP) systems. Anyone who routinely prescribes medication could benefit from digitally assisted automated checks to identify whether a prescription should potentially not be allowed (e.g. drug allergy). National Health Service (NHS) Trusts have implemented a range of EP systems; however, their performance has not hitherto been evaluated. We developed the web-based Electronic Prescribing Risk and Safety Evaluation (ePRaSE) tool, which comprises a bank of prescribing scenarios to evaluate the performance of EP systems. We solicited ePRaSE testing: 68 pharmacists from across 45 English NHS Trusts, utilising 13 different EP systems volunteered for the study. We found considerable variability in mitigation performance (systems correctly identifying risk of error when prescribing) across both NHS Trusts and EP systems. Moreover, we found that mitigation performance varied considerably across NHS Trusts using the same EP system, strongly suggesting there are opportunities to optimise performance within systems. The ePRaSE tool is effective in identifying variability in risk management between NHS Trusts and EP systems. Wider use of this tool may facilitate improvements in EP system configurations, thus minimising potential harm from prescribing errors.
处方错误是医疗保健中可预防伤害的一个来源，使用电子处方（EP）系统或许可以减轻这种情况。任何经常开处方的人都可以从数字辅助自动检查中受益，以确定某个处方是否可能不被允许（例如药物过敏）。国民保健服务（NHS）信托机构已经实施了一系列EP系统；然而，它们的性能迄今尚未得到评估。我们开发了基于网络的电子处方风险与安全评估（ePRaSE）工具，该工具包含一组处方场景，用于评估EP系统的性能。我们征集了ePRaSE测试：来自45个英国NHS信托机构的68名药剂师，使用13种不同的EP系统自愿参与了这项研究。我们发现，在NHS信托机构和EP系统中，缓解性能（系统在开处方时正确识别错误风险）存在很大差异。此外，我们发现，使用相同EP系统的NHS信托机构之间的缓解性能差异很大，这有力地表明系统内部存在优化性能的机会。ePRaSE工具可有效识别NHS信托机构和EP系统之间风险管理的差异。更广泛地使用此工具可能有助于改进EP系统配置，从而将处方错误造成的潜在伤害降至最低。
