Development of a Paperless System For Inpatient Medication Ordering at Thakradan Hospital

Abstract

Objectives: To evaluate the impact of implementing a paperless ordering system on the incidence of medication errors in the inpatient department of Thakradan Hospital.

Methods: This quasi-experimental, before-and-after study compared medication error data obtained from the hospital’s risk management information system before and after the implementation of a paperless ordering system. Data were collected during January–March 2024 (copy order system) and the same period in 2025 (paperless system). The intervention involved the use of an electronic medication prescribing and inpatient data management system (NEO IPD paperless). Descriptive statistics and the Z-test were used for data analysis.

Results: Following the implementation of the paperless ordering system, the overall medication error rate decreased from 21.61 to 20.35 incidents per 1,000 patient-days (p=0.773). Errors during the medication administration stage significantly decreased from 8.84 to 2.91 incidents per 1,000 patient-days (p=0.080). A reduction in Category C errors was observed, and no Category E (serious) errors were reported. Additionally, the system provided enhanced alert mechanisms for error prevention. However, the rate of errors during the prescribing stage significantly increased from 2.95 to 10.66 incidents per 1,000 patient-days (p=0.034), most of which were classified as Category B errors.

Conclusions: The paperless ordering system demonstrated a potential to reduce the overall medication error rate, particularly during the administration phase, and to decrease the severity of medication errors. Nevertheless, the statistically significant increase in prescribing-phase errors highlights the need for system improvements and comprehensive training for healthcare personnel to ensure accurate and efficient system usage.