Impact of Implementing Electronic Health Records on Medication Safety at an HIMSS Stage 6 Hospital: The Pharmacist's Perspective

Abstract

Background: Medication errors can cause severe injuries and may lead to death. Electronic health records (EHRs) that are well designed and implemented could help to reduce medication errors. The medication management process needs close study to understand how medication safety metrics evolve as hospitals mature in terms of their EHR implementation. Objective: To examine the effect of adopting EHRs on medication errors at the Royal Commission Hospital in Jubail, Saudi Arabia, a Health Information Management System Society (HIMSS) stage 6 hospital. Methods: This study had a quasi-experimental time-series design. Retrospective data were collected for 1.5-year periods before and after implementation of EHRs. The variables analyzed were obtained from various units in the study setting. Data on medication errors were collected from the risk management section of the quality department. The medication management process was studied qualitatively. The quantitative data were analyzed using descriptive and inferential statistics. Results: The median number of medication orders per patient showed a significant decrease, from 22.76 before EHR implementation to 18.76 after implementation (p < 0.001). The median number of incidents per patient showed a significant increase, from 0.029 before to 0.040 after implementation (p = 0.004). The qualitative analysis of processes involved in the medication management process helped to explain these changes. Conclusion: Contrary to expectations, this study showed that an HIMSS stage 6 hospital could experience an increase in medication errors following implementation of EHRs. Qualitative analysis showed that the increase in medication error reporting rate could be attributed to an increase in detection following improvement in the medication management process. This has implications for interpreting quality metrics as hospitals mature in terms of their EHR implementation.