Patient-centered health information technology has little impact on reducing pediatric medication errors in emergency departments
Research Activities, June 2009, No. 346
More than half (58 percent) of all medications prescribed to children in emergency departments (EDs) are associated with at least one error. Patient-centered health information technology (health IT) interventions are one possible way to reduce the number of these medication errors. ParentLink, a patient-centered health IT designed to enhance communication between parents and emergency providers, has minimal impact on medication errors during pediatric ED care.
The finding comes from a study of two EDs where parents brought in their children for care. Researchers compared usual care with intervention periods using the ParentLink system. Parents entered the child's symptoms, current medications, and allergies into a mobile kiosk. The system then provided ED physicians with treatment recommendations. Parents received a printout of likely ED-based actions and suggested ways to talk effectively with providers. Both usual care and ParentLink participants received a structured telephone interview 5 to 10 days after the ED visit.
ParentLink was designed to avoid common prescribing errors in emergency medicine due to miscalculated doses and drug-allergy interactions for common medications prescribed for pain, asthma, and infections. However, in this study, ParentLink demonstrated no significant impact on the rate of medication errors in ED care for children. This may have been due to the fact that certain types of medication errors related to communication and drug-allergy interactions were already low in the two EDs studied.
Another possible explanation is that 50 percent of the most common medication errors were related to deficiencies in documentation, considered outside ParentLink's range of potential impact. These included no documented order, no order time, and no signature. The highest error rate per 100 patients was found in children taking 2 or more medications at the time of the ED visit. Efforts in the future should focus on refining health IT to better integrate information produced by the patient with existing systems' data. The study was supported by the Agency for Healthcare Research and Quality (HS14947).
See "Impact of a patient-centered technology on medication errors during pediatric emergency care," by Stephen C. Porter, M.D., M.P.H., Rainu Kaushal, M.D., M.P.H., Peter W. Forbes, M.A., and others, in the September/October 2008 Ambulatory Pediatrics 8, pp. 329-335.