This document summarizes a study that compared errors in computer-assisted prescriptions (CAP) versus handwritten prescriptions (HWP) in an intensive care unit. The study analyzed 98 medical indications, 43 using HWP and 55 using CAP. It found significantly fewer errors with CAP (7.27% of prescriptions) than HWP (41.86% of prescriptions). Common errors with HWP included illegibility, transcription mistakes, and omitted information, which could lead to medical malpractice and increased health costs. The researchers concluded that using CAP could help avoid errors caused by issues with manual prescriptions.

1. 31/05/2017 1
The Effect of Computer-
assisted Prescription
in Critical Care Unit
Authors: Dr. Humberto Fernán Mandirola Brieux, Fabián Koliren, Pablo
Laguzzi & Sebastíán Guillén
speaker: Dr. Humberto F. Mandirola Brieux
Email: hmandirola@biocom.com
MEDINFO 2007
http://www.biocom.com

2. 31/05/2017 2
In this work we propose to determine in what
proportion computer-assisted prescription (CAP)
reduces errors in medical indications if we compare
it with hand-written medical prescription (HWP) in
Intensive Care Unit (ICU) in Belgrano Hospital in
Buenos Aires, Argentina.
Will determine if there are advantages between CAP
and HWP. A retrospective analysis was used over
an amount of 98 medical indications in ICU
(intensive care unit) registered during the first
quarter of 2006.
Objetive
MEDINFO 2007
http://www.biocom.com

3. Introduction
 Advantages and benefit-cost which CAP enjoys at
present are, in a way, affected by some legal aspects.
 There are existing contradictions between vanguard law
and Digital Signature Law 25.506 and General Law of
Medicine Exercise (law Nº 17132) which in its article 19
sub-sections 7 reads: “Prescriptions shall be hand-
writing, in Spanish, dated and signed”. This fact at
present complicates the situation of physicians who
use CAP because they run the risk of being sanctioned.
MEDINFO 2007

4. 31/05/2017 4
Materials and Methods
we have chosen 43 traditional hand-written
prescriptions and 55 computer-assisted
ones to elaborate this study and to
compare existing differences between
them both.
MEDINFO 2007
http://www.biocom.com

5. 31/05/2017 5
Computer Program
It consists in an electronic form with the
following fields:
drug /posology /doses /administration
route/date of beginning and end of the
treatment.
The output is the printing of a report with
daily indications for each patient.
MEDINFO 2007

6. 31/05/2017 6
Analyzed variables
 1- Incorrect information: Information which is not
relevant for patient treatment and which can lead to
confusion. Indications which do not correspond to a
patient and have been prescribed by mistake.
 2- Incorrect doses: Doses calculated by mistake or
indications wrongly transcribed.
 3- Omissions: Lack of any of the elements in the
indications, for example, when a transcription has not
been made because somebody forgot to do it.
 4- Illegibility: When two or more members from the
committee cannot understand one or more words.
MEDINFO 2007

7. 31/05/2017 7
Results
Total of prescription mistakes
(HWP) = 41,86 % (CAP)= 7,27%.
The difference between HWP and CAP is significant giving p <0,001 calculated with
incorrect information
(HWP) = 20,93 %
(CAP) = 5,45%,
incorrect doses
(HWP) = 6,98 %
(CAP)= 0%,
MEDINFO 2007
http://www.biocom.com
omissions
(HWP) = 18,60 %
(CAP)= 3,64%,
illegibility
(HWP) = 18,60 %
(CAP)= 0%.

8. 31/05/2017 8
MEDINFO 2007
http://www.biocom.com
0
2
4
6
8
10
12
14
16
18
20
HMP EMP
incorrect inf
incorrect
doses
omissions
illegibility

9. 31/05/2017 9
Discussion
Results are eloquent:
41% of mistakes in HWP vs.
7% in CAP.
Main causes in this difference are illegibility
problems and mistakes in transcription in
daily indications.
MEDINFO 2007
http://www.biocom.com

10. 31/05/2017 10
Discussion
It is important to consider that in many works
it is indicated that Medical Error has an
important incidence in morbidity and
mortality of patients and longer
permanence of patients in hospital so it
has a high incidence in increase of health
costs basically for bad administration and
limitless resources use.
MEDINFO 2007
http://www.biocom.com

11. Conclusions
It is important to consider that a wrong
manual indication could generate, for
omission, illegibility, loss, damage or
other, a medical mistake which produces a
medical malpraxis with a morbidity and
health cost easily avoidable if CAP is
used.
MEDINFO 2007
http://www.biocom.com

12. 31/05/2017 12
hmandirola@biocom.com
Thank you for your attention…!
You can send your comments,
doubts or suggestions by
email to :
MEDINFO 2007
http://www.biocom.com
http://groups.yahoo.com/group/biocom/
Dr. Humberto F. Mandirola Brieux