A published paper in the Annuals of Emergency Medicine examines four clinical scenarios that that could result in use of an emergency department information system contributing to medical errors, with recommendations to make EDIS use more safe.

The scenarios cover communication failures, poor data displays, wrong order/wrong patient errors and alert fatigues. In one scenario, instance, a physician verbally asks a nurse to give a patient with a presumed kidney stone 1 mg of hydromorphone to ease discomfort, and a half-hour later the physician finds the patient difficult to arouse. The nurse tells the physician she gave three doses of 1 mg each. The physician asks the nurse how this happened. “Well, you remember you asked me to give 1 mg of hydromorphone while we spoke in the room, then you ordered another 1 mg in computerized physician order entry, with an as needed order for a third.”

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