A report by the Institute of Medicine found that medication errors affect more than 1.5 million patients every year in the United States alone! The study also found that out of these 1.5 million, 400,000 incidents were preventable. The yearly cost of mortality and morbidity associated with inappropriate therapy or inadequacy of effective drugs swells up to billions of dollars.

Medical errors have now been termed as the third prominent cause of death in the US. Adverse drug events (ADEs) pose an additional burden on the industry as they cause over 3.5 million visits to the physician’s office and 1 million visits to the emergency department each year. Worldwide, healthcare professionals are extremely concerned by the alarming rate at which the medical errors are happening and, therefore, a lot of research is going into this field to ensure that such incidents are prevented.

Medication Errors and Their Types

The medication errors classify into nine categories from A to I based on the severity of the outcome. Let us take a look at various types of medication errors.

1. Administration errors – With 38% frequency, it may include wrong dose, route, patient and time. Staff including pharmacists, dentists, physicians, and even patients can cause ADEs. ADEs are prominent in technical scenarios where infusion pumps, nebulizers, and MDIs administer drugs.
2. Prescription errors – Also known as medical prescribing errors, prescription errors are the result of errors in written prescription or decision. These errors result in ineffective treatment and significant risk to patient’s health. They are the most common of all medical errors.
3. Dispensing errors – Pharmacists and nurses are mainly responsible for such errors. These include transcription and verification of medication. For example, medicines that look and sound alike can cause dispensing errors.

Detecting Errors

A frequent occurrence of medical errors causes substantial revenue losses for hospitals and severely hamper patient satisfaction. To slash the losses, it is essential to formulate strategies aiming to prevent their occurrence. Certain factors such as enforcing disciplinary action on reporting the error or narrow escapes discourage professionals to report similar events. It is imperative to identify the key factors leading to the failure in healthcare.  Hospitals detect the aforementioned errors by –

• Directly observing inpatient
• Pharmacy procedures
• Voluntary reporting
• Returning medicines to pharmacy
• Comparing results of physician’s prescription with that of automated dispensing device
• Testing analysis
• Preparing charts

Technology is penetrating the healthcare realm

Healthcare experts, on account of grave concerns associated with the compromising health of patients, are relying on technology. A recent study for 12-months to assess the effectiveness of Medication Error Reporting System, MEDMARX in Pennsylvania, has some interesting revelations. The system reported 17, 000 errors from 25 hospitals collectively. There was a significant rise in administering corrective measures at a constant rate. The study suggests ensuring appropriate patient care with efficiency and accuracy requires making it quintessential for organizations to institutionalize certain changes.

The emerging developments (other than implementing organizational changes) are in their embryonic stags. Advocating the implementation of the following technological tools should be encouraged –

1. Barcoding – Barcoding aims to certify accuracy through an electronic system. The system works to provide “right dose of a right drug to the right patient through a right route at a right time”. The hospital staff verifies all of these parameters and thus improves the performance by attaching CPOE with Barcode device. The technology scans the barcode of medication, nurse’s identification, and patient’s wristband to produce an electronic Medication Administration Record. The system works well with an error rate of 1 from 10 million characters evident from the stats.

2. Computerized physician order entry – Commonly referred to as CPOE, it is a package of computer-based systems ensuring legible, timely and standardized ordering of medicines. CPOE provides basic advice such as drug doses or complex ones like the interaction of the two drugs. National Non-Profit organization, The Leapfrog Group, highly recommends institutionalizing the system in hospitals to guarantee a minimum to no error events.

3. Automated drug utilization review – It is a process to ensure the appropriateness of any drug by data evaluation in the given environment against the set standards. The system is capable of effective identification of misuse of drugs, areas to save revenue and prioritize the safety of the patients.

4. Clinical Pharmacy information system – CPIS deals with inpatient and outpatient order entry, clinical monitoring, medication administration, intervention management, inventory management, purchase management, billing, and connectivity with other healthcare systems.
5. Automated drug dispensing system – It is an electronic dispense system administering pharmacists during a patient’s medication process. ADDS utilizes retranscription of the order, or it may directly attach with the electronic prescription system.

6. Clinical decision support system – This integrated electronic system was fundamentally designed to serve professionals and physicians with Clinical Decision making tasks and recommendations. Recent studies are quite evident that CDSS improved healthcare practitioner’s performance to 68% and patient’s health to 13%.

Technology has become an integral part of a multifaceted healthcare strategy where the objective is to enhance the safety and health of the patient. However, these techniques require the vigilant use and enhanced standardization to avoid any adversity.