Abstract
Objectives: To assess the efficacy of implementing an electronic health record (EHR) system in reducing the rates of medical errors (MEs) in a Saudi outpatient clinic.
Methods: A descriptive, cross-sectional study was conducted over one month on two phases: phase I (pre-EHR) and phase II (post-EHR) in 2009 and 2019, respectively. In both phases, all healthcare providers (HCPs) and employees working at the Family medicine clinic, the pharmacy and the laboratory at King Abdul Aziz Residential City Center, Riyadh, Saud Arabia, were invited to report the experienced errors during their daily work activities. A specifically-designed error note sheet was used to collect MEs allocated to 10 main categories.
Results: Prescription errors (69.3%), medication errors (13.4%) and documentation errors (6.6%) were the most frequent MEs in phase I, while communication errors, documentation errors and medication errors (38.2%, 18.7%, and 14.7%, respectively) were prevalent in phase II. As compared to manual recording, EHR system implementation reduced prescription errors (from 69.8% to 3.0%, p<0.001), medication errors (13.5% to 3.2%, p<0.001), and professionalism errors (1.9% to 0.3%, p<0.001), and completely eliminated case note missing (p<0.001) and clerical errors (p<0.001). However, communication errors increased significantly after EHR use as compared to the pre-EHR period (from 0.5% to 8.3%, p<0.001).
Conclusion: Although the majority of MEs significantly reduced with EHR implementation, some technical and/or usability barriers to its use among HCPs should be addressed. The efficacy of relevant training programs and statistical models aimed at reducing the rates of increased/unaffected MEs are to be investigated in future Saudi-based studies.
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Corresponding Author
Dr Saeed Mohammed Al-Qahtani
R3 Family Medicine Resident King Abdul Aziz Medical City- National Guard Riyadh, Saudi Arabia