• accreditation
• attitudes
• checklists

There is now widespread awareness of the very considerable burden of harm and associated costs resulting from medication errors, which, in turn, has stimulated national and international drives to reduce medication-associated harm. In parallel, there is a growing appreciation that health information technology (HIT) has the potential to reduce the risk of medication errors. There is, however, a wide gulf between HIT as a structural intervention and its translation into improvements in care processes, and a wider gulf still between the process of care and improvements in health outcomes.1 What matters to patients, and their loved ones, is of course avoidance of actual harm and it is for this reason that the WHO, in launching its Third Global Safety Challenge, called it ‘Medication Without Harm’.2

Governments across the world are investing substantial sums of money in moving care from paper-based records to electronic health record (EHR) infrastructures. A key driver for this move is the belief that this will result in substantial improvements in patient safety.3 A high frequency of medication errors and preventable adverse drug events have been documented in many studies of patient safety problems, making medication safety an obvious place to start. Yet, the analysis by Holmgren et al reported in this edition demonstrates that current EHRs would fail to prevent over one-third of potentially serious medication errors in a sample of 1527 hospitals in the USA.4 …