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How Can Information Technology Improve Patient Safety and Reduce Medication Errors in Children's Health Care?
Rainu Kaushal, MD, MPH;
Kenneth N. Barker, PhD;
David W. Bates, MD, MSc
Arch Pediatr Adolesc Med. 2001;155:1002-1007.
Background Medication errors are common, costly, and injurious to patients.
Objective To review the role of information technology in decreasing pediatric
medication errors in both inpatient and outpatient settings.
Design We performed a literature review of current information technology interventions.
Results Several types of information technology will likely reduce the frequency
of medication errors, although insufficient data exists for many technologies,
and most available data come from adult settings. Computerized physician order
entry with decision support substantially decreases the frequency of serious
inpatient medication errors in adults. Certain other inpatient information
technologies may be beneficial even though less evidence is currently available.
These include computerized medication administration records, robots, automated
pharmacy systems, bar coding, "smart" intravenous devices, and computerized
discharge prescriptions and instructions. In the outpatient setting, where
adherence is especially important, personalized Web pages and World Wide Web–based
information have substantial potential.
Conclusions Medication errors are an important problem in pediatrics. Information
technology interventions have great potential for reducing the frequency of
errors. The magnitude of benefits may be even greater in pediatrics than in
adult medicine because of the need for weight-based dosing. Further development,
application, evaluation, and dissemination of pediatric-specific information
technology interventions are essential.
From the Division of General Internal Medicine, Department of Medicine,
Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (Drs
Kaushal and Bates); and the School of Pharmacy, Auburn University, Auburn,
Ala (Dr Barker).
Corresponding author and reprints: Rainu Kaushal, MD, MPH, Division
of General Medicine, Floor PBBA 3, Brigham and Women's Hospital, 75 Francis
St, Boston, MA 02115 (e-mail: rkaushal{at}partners.org).
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