March 11, 2010

Tom Sullivan, M.D.

Cornell Study Reveals a Seven-fold Decrease in Prescription Errors When E-Prescribing

Weill Cornell Medical College and one of their research teams led by Dr. Rainu Kaushal authored a study published on February 26th in the online version of the Journal of General Internal Medicine on how using an electronic system, instead of writing prescriptions by hand, affects the frequency of prescription errors among ambulatory physicians.
The study closely reviewed 30 health care providers and the 7,000+ prescriptions they wrote over the course of one year. The clinicians using an electronic prescribing system began the study with an above average error percentage at 42.5%, but ended the year long study with only 6.6%, an impressive seven fold decrease. The 15 clinicians writing prescriptions by hand actually saw a very slight increase in the percentage of prescription errors as they went from 37.3% to 38.4% by the end of the year.

A prescription error can be defined as “any preventable event that may cause or lead to inappropriate medication use or patient harm”. A large portion of these errors are attributed to incomplete directions and bad handwriting, but incorrect dosing and adverse drug reactions do happen occasionally and might be extremely dangerous. Preventing the minor errors which were far and away the most numerous will help reduce the number of interrupting pharmacy calls to the office staff and physicians, as the pharmacist tries to clarify a prescription just sent, freeing up time for everyone involved.
Although the focus of this study is prescription errors and the tools to reduce them, there is another interesting inference to be drawn from the results. The doctors that used an electronic prescribing system started the year writing roughly 5% more incorrect prescriptions than those writing by hand. This part of the findings reinforces the importance of insuring that you are given proper training and thorough technical support when first implementing an electronic system. Although you may see a brief slowing of workflow and a slight increase in error at the outset, this is part of the normal learning curve and will quickly turn around as you gain experience and begin to reap the benefits.
You will be hard-pressed to find more conclusive evidence supporting the patient safety benefits of electronic prescribing in the ambulatory environment. What provider would not want to become 7 times less likely to write an incorrect prescription?
To read more about the study specifics visit:
For information on DrFirst and to see a demonstration of our e-prescribing product visit:

About Tom Sullivan, M.D.

Thomas E. Sullivan, M.D is a board-certified specialist in cardiology and internal medicine with over 40 years of clinical practice. He currently works for DrFirst and sees patients part-time in Massachusetts. His expertise in the application of information technology to health care has helped to create an international standard (ASTM) for the exchange of medical record information called the Continuity of Care Record (CCR). With AMA, he was founding chair of their e-Medicine Advisory Committee, worked with the Physician Consortium for Performance Improvement, represented the AMA and helped create the Physician EHR Coalition and is past chair of the AMA Council on Medical Service.