Medication safety and electronic decision support

Medication errors and inappropriate medication therapy are two of the oldest, most costly and least tractable safety problems which health systems face. Digital systems (e.g. electronic medical and health records, clinical information systems) have the potential to make medication management safer and more effective. With that expectation, health systems worldwide are making vast investments in information technology.

Our research is investigating the ways in which information technology can reduce medication errors and support improved medication therapy decisions and outcomes in hospitals, the community and aged care. Our research also aims to understand and improve the fit between users and digital systems to optimise safety, quality, productivity, and efficiency through the development of electronic decision support tools.

We apply a broad range of methods, including randomised controlled trials, field observations, interviews and focus groups, simulation, and system logs to understand how information technology is used by clinicians, and identify optimal design features. Working closely with health system and industry partners, we ensure our findings are communicated and applied in the real-world.

Our world-leading research focuses on:

Design, development, configuration, implementation and evaluation of digital interventions, including clinical decision support
Consumer engagement in design and use of digital interventions to improve medication safety
Use of electronic health record data to identify and design interventions for medication safety and quality use of medicines
Providing evidence-based guidance on digital system configuration, including via the Health Innovation Series

Stream team members

Professor Johanna Westbrook Professor and Director	Associate Professor Magda Raban Associate Professor	Associate Professor Ling Li Associate Professor	Dr Virginia Mumford Senior Research Fellow
Dr Tim Badgery-Parker Research Fellow	Dr Md Bayzidur Rahman Senior Research Fellow	Dr Rachel Urwin Research Fellow	Dr Lalit Yadav Research Fellow
Dr Rajendra Gyawali Postdoctoral Research Fellow	Dr Ryan McMullan Postdoctoral Research Fellow	Dr Isabelle Meulenbroeks Postdoctoral Research Fellow	Erin Fitzpatrick Research Officer
Alison Merchant Research Officer	Marea O'Donnell Research Officer	Joanna Clive Research Assistant	Rachel Jenkins Research Assistant
Stream coordinator Associate Professor Magda Raban Ph: 02 9850 2433

News and media

Now recruiting GPs and nurse practitioners! Are you a GP or Nurse Practitioner working in residential aged care? *Would you like to contribute to exciting research on clinical decision support?* Participants are needed for usability testing of a new clinical decision support tool from a collaborative project between the Australian Institute of Health Innovation AIHI and BESTMED. Register your interest here.
The Conversation highlights team’s work on IT flaws An article published in The Conversation highlights findings from the recently published ‘Longitudinal study of the manifestations and mechanisms of technology-related prescribing errors in pediatrics’ which examined the occurrence and changes in technology-related prescribing errors (TREs) after the implementation of an electronic medication management module in the electronic medical record. Technology-related errors are errors that are facilitated by the design or configuration of the electronic medical record. After reviewing 35,000 medication orders at a pediatric hospital, study authors found as many as one in three medication errors were technology related. Click here to read the full article by The Conversation.
The Health Innovation Series turns 2! The Health Innovation Series on e-Medication Safety publishes short form bulletins on tips for electronic system optimisation and use to improve medication safety. Click here to view all HIS issues. Launched in September 2022, the series has now published 23 bulletins. As of August 2024, the issues have had 8915 downloads from 84 countries. Feedback from electronic system managers and clinicians has been positive, with many commenting on the practical format of the evidence-based recommendations, offering a useful resource for teaching. An overview of the Health Innovation Series was presented at MedInfo 2023 - The 19th World Congress on Medical and Health Informatics. To read the conference proceeding, click here.
Article highlights consumer perspectives on antibiotic use in aged care A recent study on consumer perspectives on antibiotic use in residential aged care, led by Dr Rajendra Gyawali, emphasised the need for effective provider-consumer communication and information sharing. Perspectives varied on consumer involvement in treatment decisions, with some residents actively seeking antibiotics and others relying on doctors. However, consumers were motivated by the desire for the best possible outcomes and care for those in residential aged care. The study also revealed consumers held positive attitudes towards antibiotics, did not associate antibiotics with the exclusive treatment of bacterial infections and lacked awareness of risks like antibiotic resistance.
World Congress on Medical Informatics proceedings published The Medication Safety and Electronic Decision Support team’s papers presented at the 19th World Congress on Medical and Health Informatics were published: Designing an informatics infrastructure for a National Aged Care Medication Roundtable. (Westbrook, JI, Seaman, K, Wabe, N, Raban, MZ, Urwin, R, Badgery-Parker, T, Mecardo, C, Mumford, V, Nguyen, AD, Root, J, Balmer, S, Waugh, K, Pinto, S, Burge, B, Aldeguer, E, Dunstan, T, Jorgensen, M, Gray, L, Bucknall, T, Etherton-Beer, C, Newell, B, Caughey, G, Beattie, E, Xenos, K & Cumming, A) https://doi.org/10.3233/SHTI230996 Stepped-wedge cluster RCT to assess the effects of an electronic medication system on medication administration errors. (Westbrook, JI, Li, L, Woods, A, Badgery-Parker, T, Mumford, V & Raban, MZ) https://doi.org/10.3233/shti230981 The Health Innovation Series: translating research evidence into practice. (Raban, MZ, Merchant, A, Clay, C, Fitzpatrick, E & Westbrook, JI) https://doi.org/10.3233/SHTI230983 The economics of medication safety: a cost-benefits analysis framework for evaluating an electronic medication system. (Mumford, V, Raban, MZ, Li, L, Merchant, A, Fitzpatrick, E, Badgery-Parker, T & Westbrook, JI) https://doi.org/10.3233/SHTI231209
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