1. Decreasing Medication Errors with
Electronic Medical Records (EMRs)
Group 4B: Jason, Karen, Steven, Thu, Thienan, Selamawit,
Meaghan, Chirs & Michelle

2. Objectives
Explain medical errors and EMRs
Understand how errors are made
Determine how EMRs can help
Identify the advantages and disadvantages
Discuss the future of EMRs in the medical field

3. Introduction
What is considered a medical error?
Consequences of medical errors
Death
Excess spending
Unnecessary time, energy and added stress
What is an EMR?
Alternative names are: EHR, EPR, CPR

4. How are errors made?

5. Prescription Errors
Poor Penmanship
Error-prone
abbreviation
Dosing errors
Failure to follow
prescription guidelines
Lack of knowledge

6. Dispensing Errors
Look alike/sound
alike
Busy workplace
Failure to spot
mistake
Patient counseling

7. Administration Errors
Omissions Insertion
Repetition Incorrect
Dosage
Substitutions
Incorrect Route
Wrong patient!
Other

8. How does EMR reduce
errors?

9. Dispensing Errors
Improved data integrity:
Better organized
Easier to access client
information
Use of required fields,
uniform data entry and
trained personnel

10. Prescribing Errors: Safety
Drug-to-drug interactions
Drug-allergy interactions
Drug-disease incorrect dosage
Incorrect duration
Drug-pregnancy conflict
Drug gender conflict
OTC drugs & herbal adverse
interactions.

11. Prescribing Errors: Productivity
Available strength of drug
Alternative class
medications
Reduce refill time
Provide patient data
surveillance
Formularies are available
electronically

12. Dispensing Errors
Complete prescription
information
Less errors in
interpreting
Quicker access to provider
Quicker refill authorization
More access to patient’s
profile

13. Safety Errors
Drug-to-drug interactions
Drug-allergy interactions
Drug-disease incorrect
dosage
Incorrect duration
Drug-pregnancy conflict
Drug gender conflict

14. Advantages of EMRs

15. Advantages
Efficiency:
Retrieve patient profiles quicker
Patient access to profiles
Reduce errors
Easy to transfer information:
Ex: In natural disasters like
Hurricane Katrina or 9/11
Ex: If practice has closed or
relocated

16. Advantages
Saves money:
Cost of filing folder and paper
Cost of labor
Patients saving money
Easier billing
Saves space:
Faster work flow

17. Disadvantages of EMRs

18. Financial Issues
High Initial implementation
cost:
Time and patients lost
Cost of retained paper
processes after
Cost of training
Uncertain return on
investment

19. Personal Issues
Lack of physician support
for EMRs
Technical matters:
Difficulty using new
software
Lack of support for
technical difficulties
Inadequate consistency of
electronic records

20. Security Issues
Lack of medical policy
specific to EMRs
Potential threats:
“Inside attacks”
Information hungry
employers
Insurance
companies

21. EMR Advancements and
Policies

22. Advancements in EMR
Tablet integration in
healthcare
Check in
Data entry
Medical speech
recognition solutions
Role of smartphones in
healthcare

23. Policies Regarding EMRs
EMR government mandate:
2014 deadline
Penalties for failing
Federal incentive program:
17.2 billions in funds
Certified EMR
Eligibility
Meaningful use: Interoperability

24. Implementing EMRs
High failure rate:
Takes months to
properly install
Choosing a vendor:
Practice fusion
High cost:
Hire IT and consultants
Training

25. Questions??

26. References
1. "Avoid common pitfalls of implementing EMRs." Managed Care Contracting and Reimbursement
Advisor Oct. 2011: 5+. Health Reference Center Academic. Web. 6 Mar. 2012.
<http://go.galegroup.com.ezproxy.mcphs.edu/ps/i.do?id=GALE%7CA273587153&v=2.1&u=mcp
_main&it=r&p=HRCA&sw=w>
2. Barrows, Randolph C., Jr., and Pail D. Clayton. "Privacy, Confidentiality, and Electronic Medical
Records."Journal of the American Medical Informatics Association. 3.2 (1996): 139-148. Web. 5
Feb 2012. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC116296/pdf/0030139.pdf>.
3. Bowdie, TA. "Drug Administration Errors from ASA CLosed Claims Project." ASA Newsletter.
67.6 (2003): 11-13. Web. 22 Feb 2012.
<http://depts.washington.edu/asaccp/ASA/Newsletters/asa67_6_11_13.pdf>.
4. Buppert, Carolyn. "Electronic Medical Records: 18 Ways to Reduce Legal Risks." Medscape
News Pharmacists. (2010): n. page. Web. 22 Feb. 2012.
<http://www.medscape.com/viewarticle/714812>.
5. "Dispensing Errors – Dispensing Process." NHS Wirral. N.p., n.d. Web. 5 Mar 2012.
<http://www.wirral.nhs.uk/document_uploads/Governance/DispensingErrorsAudit.pdf>.
6. Fins, Joseph J. "Web of Care: How Will the Electronic Medical Record Change Medicine?."
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<http://www.medscape.com/viewarticle/714812>.

27. References
7. Graham, Angie S. "Prescribing Errors." California Journal of Health-System Pharmacy. (2008):
5-14. Web. 1 Mar. 2012.
<http://www.cshp.org/uploads/file/Continuing%20Education/CJHP%20CE/v20n2_ce_prescribin
g_errors.pdf>
8. Hebda, Toni, Patrica Czar, and Cynthia Mascara. Handbook of informatics for Nurses and
Health Care Professionals. 3. New Jersey : Person, Prentice Hall., 2005. 256-258. Print.
9. Jha, A.K., DesRoches, C.M., Campbell, E.G., Donelan, K., Rao, S.R., Ferris, T.G., Shields, A.,
Rosenbaum, S., Blumenthal, D. "Use of Electronic Health Records in U.S. Hospitals." New
England Journal of Medicine. 360.16 (2009): 1628-1638. Web. 10 Feb 2012.
<http://www.nejm.org/doi/full/10.1056/NEJMsa0900592>
• Jones, D. Scott, and Howard B. Kessler. "Can electronic medical records really improve
quality? The Obama administration bets yes: step right up, physicians--the electronic medical
record wizard is waiting for you." Journal of Health Care Compliance Jan.-Feb. 2010: 39+.
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7. "Medication Errors." FDA Drug Safety Newsletter. 1.4 (2008): n. page. Web. 3 Mar. 2012.
<http://www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/ucm120618.htm>.

28. References
12. Microwize Technology, Inc."Reducing Medical Errors with an Electronic
Medical Records System." Sunrise Services. N.p., n.d. Web. 12 Feb 2012.
<http://www.sunrize.com/ReducingMedicalErrorsForum.pdf>.
13. Miller, Robert H. and Sim, Ida. “Physicians’ Use of Electronic Medical Records:
Barriers And Solutions.” Health Affairs, 23. 2 (2004): 116-126. Web. 20 Feb.
2012. <http://content.healthaffairs.org/content/23/2/116.full>
14. Rama P. Nair Daya Kappil, and Tonja M. Woods. "10 Strategies for Minimizing
Dispensing Errors." Pharmacytimes. HCPLive, n.d. Web 4 Mar. 2012.
<http://www.pharmacytimes.com/media/pdf/P2PdispensingErrors.pdf>
15. Rivera, Pete. "Emr? We have an iPhone app for that ..." Healthcare Informatics
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<http://go.galegroup.com.ezproxy.mcphs.edu/ps/i.do?id=GALE%7CA22193560
5&v=2.1&u=mcp_main&it=r&p=HRCA&sw=w.>

29. References
• Sanderson, Susan. Electronic Health Records for Allied Health Careers. Boston: McGraw-Hill
Higher Education, 2009. 28-30, 98- 103. Print.
• Smith, Paul D. "Implementing an EMR System: One Clinic’s Experience." Family Practice
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<http://www.aafp.org/fpm/2003/0500/p37.html>.