Trial reportJournal of general internal medicine2011
Transitioning between electronic health records: effects on ambulatory prescribing safety.
Trial report in Journal of general internal medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- How intervention studies measure the effectiveness of medication safety-related clinical decision support systems in primary and long-term care: a systematic review.BMC medical informatics and decision making · 2024Pooled it
- Transitioning from One Electronic Health Record to Another: A Systematic Review.Journal of general internal medicine · 2023Pooled it
- Effects of health information technology on patient outcomes: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2016Pooled it
- Risks to patient safety associated with implementation of electronic applications for medication management in ambulatory care--a systematic review.BMC medical informatics and decision making · 2013Pooled it
- Barriers and facilitators to implementing electronic prescription: a systematic review of user groups' perceptions.Journal of the American Medical Informatics Association : JAMIAPooled it
- A cluster randomized trial of decision support strategies for reducing antibiotic use in acute bronchitis.JAMA internal medicine · 2013Trial
- Prescription Completeness and Selected Prescribing Indicators in Rural Vietnamese Primary Care: An Uncontrolled Before-and-After Study of a Multifaceted E-prescribing Quality Improvement Intervention.Journal of research in pharmacy practice · 2026Article
- Evaluating Clinical Staff Perceptions of EHR Usability, Satisfaction, and Adaptation to a New EHR: A Multisite, Pre-Post Implementation Study.Applied clinical informatics · 2025Article
- E-prescribing and medication safety in community settings: A rapid scoping review.Exploratory research in clinical and social pharmacy · 2023Article
- Software is Policy: Electronic Health Record Governance and the Implications of Clinical Standardization.Journal of general internal medicine · 2023Article
- From "Local Control" to "Dependency": Transitions to Single-Vendor Integrated Electronic Health Record Systems and Their Implications for the EHR Workforce.Journal of general internal medicine · 2023Article
- Medication Safety Amid Technological Change: Usability Evaluation to Inform Inpatient Nurses' Electronic Health Record System Transition.Journal of general internal medicine · 2023Article
- Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review.BMJ open · 2021Article
- Clinical decision support systems-based interventions to improve medication outcomes: A systematic literature review on features and effects.Medical journal of the Islamic Republic of Iran · 2021Review
- Electronic Health Record (EHR) Abstraction.Perspectives in health information managemen · 2021Article
- Reducing Inappropriate Outpatient Medication Prescribing in Older Adults across Electronic Health Record Systems.Applied clinical informatics · 2020Article
- Two-year longitudinal assessment of physicians' perceptions after replacement of a longstanding homegrown electronic health record: does a J-curve of satisfaction really exist?Journal of the American Medical Informatics Association : JAMIA · 2017Article
- How Physician Perspectives on E-Prescribing Evolve over Time. A Case Study Following the Transition between EHRs in an Outpatient Clinic.Applied clinical informatics · 2016Article
- Electronic prescribing: improving the efficiency and accuracy of prescribing in the ambulatory care setting.Perspectives in health information managemen · 2014Article
- A long-term follow-up evaluation of electronic health record prescribing safety.Journal of the American Medical Informatics Association : JAMIA · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundHealthcare providers previously using older electronic health records (EHRs) with electronic prescribing (e-prescribing) are transitioning to newer systems to be eligible for federal meaningful use incentives. Little is known about the safety effects of transitioning between systems.
objectiveTo assess the effect of transitioning between EHR systems on rates and types of prescribing errors, as well as provider perceptions about the effect on prescribing safety. DESIGN,
participantsProspective, case study of 17 physicians at an academic-affiliated ambulatory clinic from February 2008 through August 2009. All physicians transitioned from an older EHR with minimal clinical decision support (CDS) for e-prescribing to a newer EHR with more robust CDS. MAIN MEASUREMENTS: Prescribing errors were identified by standardized prescription and chart review. A novel survey instrument was administered to evaluate provider perceptions about prescribing safety. KEY
resultsWe analyzed 1298 prescriptions at baseline, 1331 prescriptions 12 weeks post-implementation, and 1303 prescriptions one year post-implementation. Overall prescribing error rates were highest at baseline (35.7 per 100 prescriptions, 95% confidence interval (CI) 23.2-54.8) and lowest one year post-implementation (12.2 per 100 prescriptions, 95% CI 8.6-17.4) (p < 0.001). Improvement in prescribing safety was mainly a result of reducing inappropriate abbreviation errors. However, rates for non-abbreviation prescribing errors were significantly higher at 12 weeks post-implementation than at baseline (17.7 per 100 prescriptions, 95% CI 9.5-33.0 versus 8.5 per 100 prescriptions, 95% CI 4.6-15.9) (p <0.001) and no different at baseline than one year (10.2 per 100 prescriptions, 95% CI 6.2-18.6) (p = 0.337). Survey results complemented quantitative findings.
conclusionsResults from this case study suggest that transitioning between systems, even to those with more robust CDS, may pose important safety threats. Recognizing the challenges associated with transitions and refining CDS within systems may help maximize safety benefits.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.