Part of our assignment in which we have to make a paperwork to elaborate the use of IT in order to prevent pharmaceutical errors. Created by: Annisa Hayatunnufus Bachelor of Pharmacy Management & Science University

1. SCHOOL OF PHARMACY
Subject: BIOINFORMATICS FOR PHARMACY
Subject code: SPH1062
Assignment #1
INFORMATION TECHNOLOGY IN
PHARMACEUTICAL ERROR PREVENTION
Prepared by : ANNISA HAYATUNNUFUS (ID: 012014052438)
Lecturer’s Name : IBRAHIM BIN ABDULLAH &
MOHAMMED KALEEMULLAH
Date of submission : April 10th, 2015

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I. INTRODUCTION
According to the book A Dictionary of Physics by John Daitinth, information
technology—or mostly known as IT—is defined as “an application of computers and
telecommunication equipment which functions are to store, retrieve, transmit, and
manipulate data” (Wikipedia Organization, 2015).
Despite the popular opinion of its fast growth, IT has actually been developed
since 3000 BC to 1450 AD. Afterwards, it grows all the way up to 4 ages: pre-
mechanical age, mechanical age, electromechanical age, and electronic age (Butler,
1998). Throughout these ages, various fields have been assisted by information
technology, including the pharmaceutical field.
Pharmaceutical field itself is defined as “of, relating to, or engaged in
pharmacy or the manufacture and sale of pharmaceuticals (a pharmaceutical
company).” (Merriam-Webster).
IT can be used in many ways for the pharmaceutical field. However, one of
the most important aids that the IT provides is the prevention of pharmaceutical error
itself.
Patients rely on the pharmaceutical fields to get medications, drugs, beauty
products, and many things. All of these correlate with the patient’s health. So if an
error occurs in its production, delivery, or other aspects, it can be classified as a
medication error, which leads to alter the patient’s condition.
According American Academy of Orthopaedic Surgeons, Institute of
Medicine, or mostly known as IOM, reported ±7000 deaths occur from medication
errors in hospital. In addition to that, in 2006 approximately $3.500.000.000 american
dollars are spent to prevent adverse drug events in the nation. (American Academy of
Orthopaedic Surgeons, 2008).

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The same source also stated that complex series of system problems are often
the cause of medication errors. Meanwhile, National Quality Forum of America stated
other reasons to medication error such as prescription mistakes (ie. 37% of
preventable medication errors result from dosing errors), fragmentation of care (ie.
Only 13% physicians communicate pharmacists regarding new prescriptions), and
absence of information technology infrastructure (ie. Only 4% physicians reported
having EMR systems that functions fully and had a prescribing function) (Quality
Forum Organization, 2010).
Thus, one of the best solutions to prevent such error is to use a better system
that provides more accuracy and fewer mistakes. Such tasks can be performed with
the assistance of information technology. Moreover, up until now there are lots of
works in the pharmaceutical field that the IT has helped with. Further details of those
systems will be discussed further in this paper.

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II. DISCUSSION
The main role of IT in pharmaceutical field is to perform tasks needed in the
field. It can also be used to diminish human error done by pharmaceutical
practitioners. As of now, IT has contributed through the following systems:
A. Electronic Prescribing (e-Prescribing) by Computerized Physician Order
Entry (CPOE)
Written prescription given by a physician may contribute to
medication errors that are associated with illegible and poor handwriting,
improper abbreviations and terminology, ambiguous orders, and omitted
information.
However, with the help of e-Prescribing system by Computerized
Physician Order Entry (CPOE), those errors can be reduced as much as
85% (Quality Forum Organization, 2010).
CPOE allows physicians to insert prescription orders directly in a
computer or other device. This way, pharmaceutical practitioners can
eliminate or significantly reduce the use of handwritten orders.
Right now, more developed CPOE software includes additional
safety features that enables physician to access the patient’s information—
including patient demographic information such as age, medication history,
and medication allergies. (Academy of Managed Care Pharmacy, 2010)

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B. Electronic Prescription Record
An electronic prescription record (EPR) contains all the data
legally needed to label, fill, dispense, and submit a payment request for a
particular prescription (Academy of Managed Care Pharmacy, 2010).
With this EPR, pharmacists are able to guard against drug
interactions, duplicate therapy, and drug contraindications.
Communication between health care providers can also be facilitated in
order to improve the patient care. In addition, managed health care systems
can also link EPR with the other medical record systems. This allows
prescribers to send prescriptions directly to the pharmacy that the patient
chooses. The integration between all of these systems can contribute to the
improvement of patient management. In the end, it consequently resulted
in medication errors reduction. (Academy of Managed Care Pharmacy,
2010)
C. Bar Code Electronic Medication Administration System (eMAR) or Bar-
coded Medication Administration (BCMA)
Another way to prevent pharmaceutical error is to use the bar codes
system. This technology is used to ensure that the right patient is
administered the correct medication and dose.
This particular technology is a personalized system that is attached
to every patient’s identification bracelet. With this technology, the nurse
who administers the medication directly to the patient should scan the
bracelet and the administered medication dose. If there is any mismatch of
patient’s identity such as name, dose, or the medication’s route of

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administration, then the system will alert the nurse right away
(Ponnuswamy, 2014). This way, the BCMA is able to ensure the
appropriate five ‘rights’ of medication administration: the right drug,
patient, route, dose, and time. (Agrawal, 2009)
51% reduction in medication errors have been achieved by
confirming the correct drug dosage with eMAR technology. (Quality
Forum Organization, 2010)
D. Electronic DUR (Drug Utilization Reviews)
Electronic DUR is a system that is dependent on the presence of
EPR. The review itself is a significant process in which pharmacist is able
to deal with potential drug-patient problems (in examples: drug-drug
interactions, over-use and under-use of drugs, and medication allergies).
Electronic DUR enables the user to do the review online, rather
than manually. It can also be used to determine the correct medication
therapy by matching it with the information stored in the patient’s medical
record or from the pharmacy record itself.
Medication safety issues that are associated with this system
includes drug-disease contraindications, drug-drug interactions, incorrect
drug dosage, inappropriate duration of drug treatment, drug-allergy
interactions, and clinical abuse or misuse (Academy of Managed Care
Pharmacy, 2010)

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E. Automated Medication Dispensing
This system is useful to perform a method in dispensing medication
where a lot of errors can occur due to manual monotonous, repetitive
motions that requires high concentration from the practitioner and reliable
record keeping. Many automated dispensing systems have now use the bar
code technology (eMAR or BCMA) discussed earlier in order to guarantee
the five ‘rights’ of medication administration. (Academy of Managed Care
Pharmacy, 2010)

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III. CONCLUSION
Pharmaceutical errors (or medication error, to be more specific) is an
unfortunate event that will always occur in any pharmaceutical field. Even so, the
errors can actually be reduced or even eliminated with the help of information
technology. IT helps pharmaceutical practitioners by performing certain works that, if
done manually, have often resulted in medication errors.
As of now, some of the examples of the use of IT in the pharmaceutical field
are electronic prescribing, Computerized Physician Order Entry (CPOE), Bar Code
Electronic Medication Administration System (eMAR) or Bar-coded Medication
Administration (BCMA), Electronic DUR (Drug Utilization Reviews), and
Automated Medication Dispensing.
However, first and foremost, in order to develop even further technology like
what have been discussed above, we need to investigate the cause of the error in the
first place. Therefore, IT can be reliable at times, but we should be able to understand
how to perform those pharmaceutical tasks first.
Thus, the last conclusion in order to decrease pharmaceutical errors even
further is that pharmaceutical practitioners should be able to cooperate by performing
their own task properly according to the standard operating procedure (SOP) and
avoid making too much mistakes. Because in the end, it is not only machine or
technology that is going to do all the work. Information technology needed
supervision or constant monitoring from humans as well.

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IV. REFERENCES
1. Academy of Managed Care Pharmacy. (2010, June). The AMCP's Concepts in
Managed Care Pharmacy: Medication Errors. Retrieved from AMCP:
http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=9300
2. Agrawal, A. (2009, June). Medication Errors: Prevention Using Information
Technology Systems. Retrieved from US National Library of Medicine, National
Institutes of Health: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723209/
3. American Academy of Orthopaedic Surgeons. (2008, December). Information
Statement: Prevention of Medication Errors. Retrieved from The American
Academy of Orthopaedic Surgeons/The American Association of Orthopaedic
Surgeons: http://www.aaos.org/about/papers/advistmt/1026.asp
4. Butler, J. G. (1998, July 13). A History of Information Technology and Systems.
Retrieved from Telecommunication and Film Department, University of Alabama:
http://www.tcf.ua.edu/AZ/ITHistoryOutline.htm
5. Merriam-Webster. (n.d.). Dictionary: pharmaceutical. Retrieved from Merriam-
Webster: http://www.merriam-webster.com/dictionary/pharmaceutical
6. Ponnuswamy, T. (2014). Role of Information Technology in Preventing
Medication Errors: An Overview. International Journal of Pharmaceutical &
Biological Archives, 19-22.
7. Quality Forum Organization. (2010, December). Preventing Medication Errors: a
$21 Billion Opportunity. Retrieved from National Quality Forum:
https://www.qualityforum.org/NPP/docs/Preventing_Medication_Error_CAB.asp
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8. Wikipedia Organization. (2015, March 25). Information Technology. Retrieved
from Wikipedia: http://en.wikipedia.org/wiki/Information_technology