Evidence map›Paper›PMID 39259924›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2025

Longitudinal study of the manifestations and mechanisms of technology-related prescribing errors in pediatrics.

Magdalena Z Raban, Erin Fitzpatrick, Alison Merchant, Bayzidur Rahman, Tim Badgery-Parker, Ling Li, Melissa T Baysari, Peter Barclay, Michael Dickinson, Virginia Mumford and 1 more

Abstract read
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Magdalena Z RabanCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.ORCID 0000-0002-6995-2849
Erin FitzpatrickCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.
Alison MerchantCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.
Bayzidur RahmanCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.
Tim Badgery-ParkerCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.
Ling LiCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.ORCID 0000-0002-1642-142X
Melissa T BaysariSchool of Medical Sciences, Biomedical Informatics and Digital Health, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia.ORCID 0000-0003-1645-9126
Peter BarclayDepartment of Pharmacy, The Sydney Children's Hospital Network, Sydney, New South Wales 2145, Australia.
Michael DickinsonDigital Health Services, South Western Sydney Local Health District, Sydney, New South Wales 2170, Australia.
Virginia MumfordCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.ORCID 0000-0001-7915-0615
Johanna I WestbrookCentre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales 2109, Australia.ORCID 0000-0003-1083-8192

Funding

eHealth, New South WalesNHMRC APP1094878NHMRC APP1174021NHMRC Early Career Fellowship APP1143941NHMRC Partnership APP1094878Office of Kids and Families, New South WalesSydney Children's Hospitals Network
6 · The paper itself

Abstract

objectivesTo examine changes in technology-related errors (TREs), their manifestations and underlying mechanisms at 3 time points after the implementation of computerized provider order entry (CPOE) in an electronic health record; and evaluate the clinical decision support (CDS) available to mitigate the TREs at 5-years post-CPOE. MATERIALS AND

methodsPrescribing errors (n = 1315) of moderate, major, or serious potential harm identified through review of 35 322 orders at 3 time points (immediately, 1-year, and 4-years post-CPOE) were assessed to identify TREs at a tertiary pediatric hospital. TREs were coded using the Technology-Related Error Mechanism classification. TRE rates, percentage of prescribing errors that were TREs, and mechanism rates were compared over time. Each TRE was tested in the CPOE 5-years post-implementation to assess the availability of CDS to mitigate the error.

resultsTREs accounted for 32.5% (n = 428) of prescribing errors; an adjusted rate of 1.49 TREs/100 orders (95% confidence interval [CI]: 1.06, 1.92). At 1-year post-CPOE, the rate of TREs was 40% lower than immediately post (incident rate ratio [IRR]: 0.60; 95% CI: 0.41, 0.89). However, at 4-years post, the TRE rate was not significantly different to baseline (IRR: 0.80; 95% CI: 0.59, 1.08). "New workflows required by the CPOE" was the most frequent TRE mechanism at all time points. CDS was available to mitigate 32.7% of TREs. DISCUSSION: In a pediatric setting, TREs persisted 4-years post-CPOE with no difference in the rate compared to immediately post-CPOE.

conclusionGreater attention is required to address TREs to enhance the safety benefits of systems.

Indexed as

Decision Support Systems, ClinicalElectronic Health RecordsMedical Order Entry SystemsMedication ErrorsChildHospitals, PediatricHumansLongitudinal StudiesPediatricselectronic health recordsinformaticsmedication errorspatient safetyuser-centered design

Identifiers

PMID39259924
PMCPMC11648728

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.