The risk of medication errors using EHR

Medication errors in an electronic health record (EHR) system can encompass a range of mistakes or discrepancies that occur during the prescribing, dispensing, or administering medications. These errors may result from various factors, including system design, user input, or communication breakdowns. According to the study Impact of Implementing Electronic Health Records on Medication Safety at an HIMSS Stage 6 Hospital: The Pharmacist’s Perspective, these errors “may occur in the storage, prescribing, transcription, preparation and dispensing, or administration and monitoring of medications.”

Types of medication errors

According to the study Medication Dispensing Errors and Prevention, medication errors linked to electronic health records (EHRs) can occur at different stages of the medication process. While EHR systems are designed to improve safety, poor system design, alert fatigue, or user mistakes can still lead to errors. Common types of EHR medication errors include:

• Prescribing and ordering errors: These occur when the wrong medication, dose, frequency, or duration is selected in the EHR. Drop-down menus, auto-fill features, or ignored clinical decision support alerts can contribute to these mistakes.
• Documentation and transcription errors: Incomplete, outdated, or incorrect medication information recorded in the EHR can lead to misunderstandings between healthcare providers or incorrect instructions being followed.
• Dispensing errors: These happen when pharmacies dispense the wrong medication, strength, or formulation due to unclear or inaccurate EHR entries or communication gaps between systems.
• Administration errors: Errors may occur when the wrong medication is given, at the wrong time, via the wrong route, or to the wrong patient, sometimes due to barcode scanning failures or incorrect EHR records.
• Monitoring errors: These involve failures to track patient allergies, drug interactions, side effects, or lab results, which may be overlooked if EHR alerts are missed or poorly displayed.
• Compliance errors: Even when correct information is available in the EHR, errors can occur if clinicians do not follow established protocols or safety guidelines.

Impact of medication errors

Medication errors can have serious consequences for patients, healthcare professionals, and healthcare systems. The study titled Impact of Implementing Electronic Health Records on Medication Safety at an HIMSS Stage 6 Hospital: The Pharmacist’s Perspective, indicates that medication errors remain a significant cause of preventable patient harm, even in healthcare settings that use EHRs. These errors can result in adverse drug events, leading to patient injury, complications, and, in severe cases, death.

From a patient safety perspective, medication errors are associated with longer hospital stays, delayed recovery, and the need for additional medical interventions. Patients may experience side effects, allergic reactions, or worsening of their condition due to incorrect medications or doses. Beyond physical harm, such errors can also reduce patient confidence and trust in healthcare services.

The study further shows that medication errors place a financial burden on healthcare systems. Preventable errors increase costs through extended hospitalisation, additional treatments, and increased use of healthcare resources. These costs can strain healthcare facilities and limit their ability to deliver efficient, high-quality care.

Importantly, the study notes that an increase in reported medication errors following EHR implementation may reflect improved error detection and reporting, rather than a decline in care quality. Better reporting allows healthcare organisations to identify system gaps and improve medication safety practices. Overall, the impact of medication errors extends beyond individual patients, affecting healthcare quality, safety culture, and operational costs.

How to avoid medication errors

Preventing medication errors requires a mix of better systems, clear communication, and teamwork across the healthcare process. According to the Medication Dispensing Errors and Prevention article, multiple strategies have been shown to reduce errors at different stages of care and improve overall patient safety.

Key strategies to prevent medication errors include:

• Adopting technology that supports safe prescribing: Tools like computerized physician order entry (CPOE) and clinical decision support systems help clinicians enter orders clearly, check for drug interactions, and alert users to potential problems before they happen. Studies show that such electronic systems can significantly reduce prescribing errors when they are used well.
• Using barcodes and automated identification: Barcode scanning for patients and medications helps make sure the right person gets the right medicine at the right time. These systems act like a safety net and catch errors that might otherwise slip through manual processes.
• Medication reconciliation: Regularly reviewing a patient’s full list of medications, especially when they are admitted, transferred, or discharged, helps catch discrepancies and ensure everyone on the care team has accurate information about what the patient is taking.
• Reducing interruptions for clinicians: Interruptions during medication preparation and administration are linked with higher error rates, so creating “quiet zones” or focused time for these tasks can help nurses and pharmacists stay focused.
• Improving pharmacy processes: Standardised protocols in pharmacies, such as double-checking high-risk medications, confirming allergies and interactions, and ensuring clear labelling, help prevent dispensing errors before medications leave the pharmacy.
• Encouraging reporting and learning from errors: A culture where healthcare workers can report errors or “near misses” without fear of punishment helps organisations learn from mistakes and adjust systems, training, or workflows to avoid repeating them.
• Team communication and collaboration: When doctors, nurses, pharmacists, and other clinicians communicate openly and work together, such as discussing unclear orders or verifying medication lists, it strengthens safety processes and reduces misunderstandings.

Success in preventing errors doesn’t come from a single solution but from combining these approaches in a coordinated way. When healthcare teams use technology wisely, follow safe practices, and prioritise clear communication, the risk of medication errors can be significantly lowered.

See also: HIPAA Compliant Email: The Definitive Guide

FAQs

What are the medical errors caused by the EHR?

While using EHRs can improve physician productivity and increase patient satisfaction, they also introduce new sources of error. These include problems with information display, difficult data entry, and failure to alert users of potential risks.

What is the medication management system in an EHR?

The EHR provides details about the medication order, including the dosage, route, frequency, and additional information from the provider who created the order.

How does EHR function?

EHR software eliminates the need for health providers to individually obtain written records of a patient. Instead, clinicians can easily collect all necessary data including charts, notes and other relevant information from various healthcare sources through this technology. Moreover, it enables their care team to access and update such important details in real-time as well.

How do prescription errors contribute to medication errors?

Errors made in the prescription can introduce medication errors via:

• Illegible handwriting: Misreading or misinterpreting handwritten prescriptions can lead to dispensing the wrong medication or dosage.
• Abbreviation confusion: Misunderstandings related to abbreviations can result in prescribing the wrong medication, incorrect dosage, or inappropriate administration.
• Dosage errors: Prescribing the wrong dosage can lead to underdosing or overdosing, potentially causing harm to the patient.