Grace Kuo, Pharm. D., Jeffrey Steinbauer, M.D., Robert J. Volk, Ph.D. (Funded by AHRQ)

Every year, from 44,000 to 98,000 people in the United States die as a result of medical errors. One common medical error involves medication error (e.g., prescribing or administering the wrong medication, incorrect dosing, drug interactions, failure to order therapeutic monitoring tests). Data on medication errors are collected predominantly in hospitals where it is easier to monitor such errors and to identify patients experiencing adverse drug events. However, in the United States, most medications are prescribed by primary care physicians in the outpatient setting. While computerized physician order entry systems (CPOE) have been shown to decrease ME in the inpatient setting, its effect at the point of care in the outpatient setting has not been well studied. The specific aim of this two-year study is to determine the frequency, type, severity, and preventability of medication errors in primary care settings that use an electronic medical record (EMR) with advanced decision support at the point of care, compared to primary care settings where a paper medical record (PMR) without advanced decision support is used. The study will be conducted in four clinical settings, each representing one constituent organization of the Southern Primary care Urban Research Network (SPUR-Net^SM), which is located in Houston, Texas, and administered by Baylor College of Medicine. Two sites use an EMR, Logician®, and two use PMR.

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