Navigating Medication Safety with Electronic Medical Records: Insights from a Dual-Phase Implementation in Paediatric, Neonatal and Maternity Care

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Abstract Objective EMR implementations can lead to changes in medication safety events due to the disruption of clinical activities by the implementation. The current study aimed to evaluate the impact of an Electronic Medical Record (EMR) implementation on medication safety events within women’s and children’s services of a large tertiary public hospital. Methods This Real-World Evidence (RWE) study utilised a differences-in-differences analysis with negative binomial regression to accommodate overdispersion in medication safety event counts. We compared change over time in key outcomes between areas where the EMR was activated and areas where it was not activated. Data were collected from January 2020 to February 2024 from the enterprise incident management system, spanning periods before and after two separate EMR system activations in 2021 and 2023. Results There was an initial rise in minor and near-miss incidents immediately following activation, with no overall increase in events in groups not activated. The observed rise in incidents was in the time immediately around the activation and was not sustained over the longer term. There were no significant changes in trend over time. Conclusions Our findings suggest that the implementation of the EMR system was not associated with a change in the occurrence of medication safety events over the longer term. Our study highlights the potential of EMR systems to be integrated into healthcare settings without worsening medication safety outcomes; implementation also doesn’t appear to have improved rates.

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