{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:15:14Z","timestamp":1785420914951,"version":"3.56.0"},"reference-count":8,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0This project is part of a broader effort to develop a new electronic registry for ophthalmology in the KwaZulu-Natal (KZN) province in South Africa. The registry should include a clinical decision support system that reduces the potential for human error and should be applicable for our diversity of hospitals, whether electronic health record (EHR) or paper-based.\n\nMethods:\u00a0Post-operative prescriptions of consecutive cataract surgery discharges were included for 2019 and 2020. Comparisons were facilitated by the four chosen state hospitals in KZN each having a different system for prescribing medications: Electronic, tick sheet, ink stamp and handwritten health records. Error types were compared to hospital systems to identify easily-correctable errors. Potential error remedies were sought by a four-step process.\n\nResults:\u00a0There were 1307 individual errors in 1661 prescriptions, categorised into 20 error types. Increasing levels of technology did not decrease error rates but did decrease the variety of error types. High technology scripts had the most errors but when easily correctable errors were removed, EHRs had the lowest error rates and handwritten the highest.\n\nConclusion:\u00a0Increasing technology, by itself, does not seem to reduce prescription error. Technology does, however, seem to decrease the variability of potential error types, which make many of the errors simpler to correct.\n\nContribution:\u00a0Regular audits are an effective tool to greatly reduce prescription errors, and the higher the technology level, the more effective these audit interventions become. This advantage can be transferred to paper-based notes by utilising a hybrid electronic registry to print the formal medical record.<\/jats:p>","DOI":"10.4102\/safp.v66i1.5845","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T18:17:58Z","timestamp":1717784278000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid electronic record: An error reduction strategy for diverse medical prescription formats"],"prefix":"10.4102","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8805-8383","authenticated-orcid":false,"given":"Carl-Heinz","family":"Kruse","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6954-153X","authenticated-orcid":false,"given":"Michelle T.D.","family":"Smith","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8467-1455","authenticated-orcid":false,"given":"Damian L.","family":"Clarke","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"key":"ref0","unstructured":"Institute of Medicine (US) Committee on Quality of Health Care in America. To err is human: Building a safer health system [homepage on the Internet]. Kohn LT, Corrigan JM, Donaldson MS, editors. Washington, DC: National Academies Press (US); 2000 [cited 2023 Oct 03]. Available from: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK225182\/"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Gawande A. The checklist manifesto: How to get things right. 1st ed. New York: Picador, 2011; 240 p.","DOI":"10.1016\/S2155-8256(15)30310-0"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Reason J. The human contribution: Unsafe acts, accidents and heroic recoveries. CRC Press, 2017; 247 p.","DOI":"10.1201\/9781315239125"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Laing GL, Bruce JL, Skinner DL, Allorto NL, Clarke DL, Aldous C. Development, implementation, and evaluation of a hybrid electronic medical record system specifically designed for a developing world surgical service. World J Surg. 2014 Jun 1;38(6):1388\u20131397. https:\/\/doi.org\/10.1007\/s00268-013-2438-2","DOI":"10.1007\/s00268-013-2438-2"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Laing G, Bruce J, Skinner D, et al. Using a hybrid electronic medical record system for the surveillance of adverse surgical events and human error in a developing world surgical service. World J Surg. 2015;39(1):70\u201379. https:\/\/doi.org\/10.1007\/s00268-014-2766-x","DOI":"10.1007\/s00268-014-2766-x"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Kruse CH, Smith MTD, Clarke DL. Technology alone does not achieve error reduction \u2013 A study of handwritten, tick-sheet, ink stamp and electronic medical prescriptions. S Afr J Surg. 2022;60(4):259\u2013267. https:\/\/doi.org\/10.17159\/2078-5151\/SAJS3670","DOI":"10.17159\/2078-5151\/SAJS3670"},{"key":"ref6","unstructured":"South African Government. Medicines and Related Substances Act (previously Drugs Control Act) 101 of 1965 | South African Government [Internet]. [cited 2023 Dec 18]. Available from: https:\/\/www.gov.za\/documents\/drugs-control-act-7-jul-1965-0000"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Francis D, Webster E. Poverty and inequality in South Africa: Critical reflections. Dev South Afr. 2019;36(6):788\u2013802. https:\/\/doi.org\/10.1080\/0376835X.2019.1666703","DOI":"10.1080\/0376835X.2019.1666703"}],"container-title":["South African Family Practice"],"original-title":[],"link":[{"URL":"https:\/\/safpj.co.za\/index.php\/safpj\/article\/viewFile\/5845\/8840","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/safpj.co.za\/index.php\/safpj\/article\/viewFile\/5845\/8841","content-type":"application\/epub+zip","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/safpj.co.za\/index.php\/safpj\/article\/viewFile\/5845\/8842","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/safpj.co.za\/index.php\/safpj\/article\/viewFile\/5845\/8843","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/safpj.co.za\/index.php\/safpj\/article\/view\/5845\/8843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T12:01:43Z","timestamp":1774958503000},"score":1,"resource":{"primary":{"URL":"https:\/\/safpj.co.za\/index.php\/safpj\/article\/view\/5845"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,7]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,30]]}},"URL":"https:\/\/doi.org\/10.4102\/safp.v66i1.5845","relation":{},"ISSN":["2078-6190","2078-6204"],"issn-type":[{"value":"2078-6190","type":"print"},{"value":"2078-6204","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,7]]},"article-number":"a5845"}}