An e-Delphi study to obtain expert consensus on the level of risk
associated with preventable e-prescribing events.
Abstract
Objectives We aim to seek expert opinion and gain consensus on the risks
associated with a range of prescribing scenarios, preventable using
e-prescribing systems, to inform the development of a simulation tool to
evaluate the risk and safety of e-prescribing systems (ePRaSE). Methods
We conducted a two-round eDelphi survey where expert participants were
asked to score pre-designed prescribing scenarios using a five-point
Likert scale to ascertain the likelihood of occurrence of the
prescribing event, likelihood of occurrence of harm and the severity of
the harm. Results Twenty four experts consented to participate with
fifteen participants and thirteen participants completing rounds 1 and 2
respectively. Experts agreed on the level of risk associated with 136
out of 178 clinical scenarios with 131 scenarios categorised as high or
extreme risk. Discussion We identified 131 extreme or high-risk
prescribing scenarios that may be prevented using e-prescribing clinical
decision support. The prescribing scenarios represent a variety of
categories, with drug-disease contraindications, being the most frequent
representing 37 (27%) scenarios and antimicrobial agents being the most
common drug class representing 28 (21%) of the scenarios. Conclusion
Our eDelphi study has achieved expert consensus on the risk associated
with a range of clinical scenarios with most of the scenarios
categorised as extreme or high risk. These prescribing scenarios
represent the breadth of preventable prescribing error categories
involving both basic and advanced clinical decision support. We will use
the findings of this study to inform the development of the
e-prescribing risk and safety evaluation tool.