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EHR default values could lead to medication errors

November 6, 2013
by Richard R. Rogoski
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While default values are commonly used to add standardization and efficiency to electronic health records and computerized provider order entry (CPOE) systems, a recent study conducted by the Pennsylvania Patient Safety Authority, an independent state agency, showed that patient harm can occur if these default values are used inappropriately or are not updated.

Looking at an initial 1,249 reports that occurred from June 19, 2004 through February 15, 2013, the team of analysts headed by Senior Patient Safety Analyst Erin Sparnon, selected the 487 reports that included the term "default" and verified that 324 of these were relevant for the study because they were directly related to default values in the EHR software. 

In their study entitled "Spotlight on Electronic Health Record Errors: Errors Related to the Use of Default Values," the analysts concluded: "Reports of wrong-time errors were the most prevalent followed by wrong-dose errors, inappropriate use of auto-stops, and wrong-route errors. When available, the cause of the error was assessed as well; failure to change a default value was reported most frequently, followed by user entries overwritten by the system, default values inserted into incomplete orders, and inability to change a default value."

They also noted that "several reports indicated that a default value needed to be updated to match clinical practice."