Qual Saf Health Care 19:262-263 doi:10.1136/qshc.2010.040337
  • Commentary

Progress in paediatric electronic prescribing: good, better, best

  1. Kathleen E Walsh1,2
  1. 1Department of Pediatrics, University of Massachusetts School of Medicine, Worcester, Massachusetts, USA
  2. 2Meyers Primary Care Institute, Worcester, Massachusetts, USA
  1. Correspondence to Dr Kathleen E Walsh, Benedict Second Floor, UMass Medical Center 55 North Lake, St Worcester, MA 01655, USA; walshk02{at}

    As a physician trainee, I used several different electronic health records at different institutions. In an e-prescribing training environment, I once wrote an electronic order for a large overdose of digoxin for a neonatal test patient. I was disturbed to find that the electronic prescribing system printed that order without any warnings or alerts because it fit within the normal adult dosing limits for the medication. For special patient populations, such as children, electronic health records, particularly prescribing systems, require special features.1 Children have higher rates of potentially dangerous medication errors than adult patients, due to the complexity of paediatric medication ordering with individualised weight-based dosing.2 Electronic prescribing systems designed for adult patients may not contain the paediatric decision support needed to prevent paediatric medication errors or may even cause new paediatric errors to occur.

    The Jani et al paper (see page 337) raises several important issues regarding the effect of electronic prescribing on paediatric dosing errors.3 Prominent among them are: first, the role of clinician decision support in electronic prescribing; …

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