Maine Med reduces prescription errors

PORTLAND – Maine Medical Center says a computerized system implemented for prescription drugs last year has reduced transcription errors by 78 percent.

From January to March, there were 23 mistakes using the new system, compared to 103 mistakes in the same period last year.

“We have a goal of zero percent,” said Dr. George Higgins, interim chief medical officer at the state’s largest hospital.

More than half of Maine’s 38 hospitals plan to install computerized physician order entry systems or already have them. It’s the breadth of Maine Medical Center’s program, however, that has made the hospital a leader in health care’s digital revolution.

At Maine Med, nearly 1,000 doctors, nurse practitioners and physician assistants enter orders into 600 computers stationed around the hospital.

The goal was to eliminate illegible handwritten prescriptions that can cause errors leading to allergic reactions or overdoses.

Before the computer system was implemented, the number of errors reaching patients was less than 1 percent. But the hospital implemented the computer system in hopes of doing even better.

Computerized systems do more than eliminate transcription error. Using patient information, these systems can warn hospital personnel about common prescribing errors – these alerts must be overridden to proceed – and provide links to the latest information on new drugs.

If a doctor, for example, accidentally requests 12 tablets of blood thinner rather than one, a box will flash on the screen warning of a dose “outside normal dose parameters.”

Computerization has been pushed as a solution to medical errors since a federal report in 1999 estimated that 98,000 deaths a year may have been caused by the mistakes of doctors, nurses and other personnel.

But computer systems have been slow to take hold, largely because of the multimillion-dollar cost of buying software, updating hardware and training personnel – a giant roadblock for smaller hospitals in rural Maine.

“We’re not that far along at this point,” said Dan Marois at Franklin Memorial Hospital in Farmington, which is converting paper files to electronic records. “You can only tackle one thing at a time.”

Doctors also have resisted computerized patient care. Cedars-Sinai Medical Center in Los Angeles last year yanked its system after doctors complained that typing up orders cut into their busy work days.

Worries about a revolt are partly why Southern Maine Medical Center in Biddeford is taking its time to work with a vendor on developing a system that their doctors will like.

“If you get it wrong, it’s not pleasant because doctors are busy and they want to be efficient,” said Dr. Terry Sheehan, medical director at SMMC, which plans to launch its system in a year.