Doctors struggle with transition, but e-records appear superior

Researchers at Cornell publish a report finding that, under a new electronic record-keeping system, prescription errors dropped from 36 percent to 12 percent in one year.

As many hospitals and health care centers across the U.S. switch from paper record-keeping to newer, electronic health record systems that qualify them for federal incentives, a team of physician-scientists at Weill Cornell Medical College has been tracking the transition for 19 physicians at an adult ambulatory clinic.

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Nearly 4,000 prescriptions for more than 2,000 patients were tracked before the switch, 12 weeks after the switch, and a year after the switch. Researchers found that prescription errors dropped by two-thirds, from 36 percent to 12 percent a year after their physicians had switched to electronic record-keeping systems.

Furthermore, the rate of improper abbreviations (i.e. using the outdated "QD" instead of "once daily") dropped by three-quarters, from 24 percent to 6 percent a year later.

And while the rate of errors that did not involve abbreviations actually doubled from 9 percent to 18 percent over the first 12 weeks, it dropped back down to 9 percent when measured a year later.

Still, in spite of the evidence that the newer system results in fewer mistakes and thus improved efficiency--and likely safety-- the 19 physicians had a few reservations. In the survey, two-thirds of the physicians reported that the new system slowed down drug orders and refills; 40 percent weren't satisfied with the implementation of the new system; and only one-third thought the system was safer.

"Transitioning between systems, even among providers who are used to electronic health records, can be problematic," said senior author Dr. Rainu Kaushal at the Departments of Pediatrics and Public Health at Weill. Still, she adds, the system is clearly "very effective at reducing certain types of prescribing errors."

Whether physician dissatisfaction is the result of mere growing pains or a sign that the system studied needs improving, the report suggests that what is clear is that the new system is outperforming the old. It comes on the heels of the team's 2010 study showing a seven-fold decrease in medication errors thanks to e-prescriptions.

The results of this study appear in the Journal of General Internal Medicine.

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About the author

Elizabeth Armstrong Moore is based in Portland, Oregon, and has written for Wired, The Christian Science Monitor, and public radio. Her semi-obscure hobbies include climbing, billiards, board games that take up a lot of space, and piano.

 

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