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Impact of Electronic Health Record Systems on Prescribing Errors in Pediatric Clinics

1
College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK 73096, USA
2
School of Community Medicine, University of Oklahoma, Tulsa, OK 74135, USA
3
Saint Francis Health System, Inc., Tulsa, OK 74136, USA
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(2), 57; https://doi.org/10.3390/healthcare7020057
Received: 13 February 2019 / Revised: 28 March 2019 / Accepted: 31 March 2019 / Published: 5 April 2019
(This article belongs to the Special Issue Rational Use of Medicines in Children)
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Abstract

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. View Full-Text
Keywords: pediatrics; children; prescribing errors; medication; electronic health records pediatrics; children; prescribing errors; medication; electronic health records
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Gildon, B.L.; Condren, M.; Hughes, C.C. Impact of Electronic Health Record Systems on Prescribing Errors in Pediatric Clinics. Healthcare 2019, 7, 57.

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