Document Type


Degree Name



Department of Medical Informatics and Clinical Epidemiology


Oregon Health & Science University


Introduction: Medical informatics transforms medicine through the use of electronic health records (EHRs) and computerized physician order entry. Prescriptions created by computerized physician order entry have been shown to reduce medical errors compared to handwritten prescriptions. However, 10 percent of computer-generated prescriptions still contain errors. This project was to develop rules for improving the computer interface for a commercial EHR. Methods: 536 medications were reviewed from the pediatric formulary of HealthPartners clinics. Potential errors in the medication lists were documented, and a set of rules was established to revise the medication preference list for the EHR. A new pediatric preference list was created in the proof of concept environment of the EHR. The new preference list was developed to be cleaner, easier to use, and intuitive. Test cases were also created to evaluate the new preference list. Results: The new preference list was evaluated by physician test subjects. Three out of seven subjects noted a discernible difference in the new preference list compared to the old (current) preference list. There was overwhelming agreement that the new preference list was intuitive, preferable to the old preference list, and should be integrated into the EHR. Discussion: Many difficulties in the ordering of medications were improved using empiric rules developed for a prescription preference list. Changes to the preference list included modifications of the display name template, revising dose, frequency and route defaults and cataloguing changes needed to be made by the organization.

Conclusion: Computerized physician order entry has been shown to reduce prescription errors. This project developed rules to improve the medication preference lists used to create prescriptions in pediatrics. Findings should be generalizable to other disciplines and possibly to other EHRs.




School of Medicine



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