Document Detail


Faxed Arabic prescriptions: a medication error waiting to happen?
MedLine Citation:
PMID:  22178294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The Arabic language uses notations called diacritical marks around characters to change which letter a symbol represents, changing the word in which that letter is contained. We explore the potential for error of these marks when faxed in a critical case such as prescriptions. A large number of patients are hurt by medical errors each year. Extensive literature already documents the risks from handwritten prescriptions, while little work has been done with risks from reproduced printed prescriptions. No literature exists to examine risks of prescriptions in non-Roman character alphabets being reproduced. Reproduction via fax transmission is a common practice and often produces damaged copies which can lead to medication errors. Languages with diacritical marks, particularly small ones, used for critical contextual meaning would more likely be at risk for misreading due to fax damage.
METHODS: We generated text in English and Arabic reproducing common prescribing instructions, such as "every day" at various font sizes. This was placed on commonly used prescription paper, and reproduced via fax between 2 medical facility fax machines.
RESULTS: We demonstrate meaningful change of prescribing instructions in the Arabic text by both the fax compression algorithm changing the appearance of diacritical marks along with a large amount of stochastic noise and dropouts being present. This change produced a potentially dangerous change in the instructions in the example we present.
CONCLUSIONS: Prescriptions that are faxed in languages that use diacritical marks to denote contextual meaning, are at high risk for misreading when reproduced via fax. We suggest mitigating strategies, including minimal font size and use of alliteration text in other languages.
Authors:
H J Feldman; H Al-Jalahma; R Al-Ali; S Reti
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Publication Detail:
Type:  Journal Article     Date:  2011-12-16
Journal Detail:
Title:  International journal of medical informatics     Volume:  81     ISSN:  1872-8243     ISO Abbreviation:  Int J Med Inform     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-14     Completed Date:  2012-07-24     Revised Date:  2014-08-19    
Medline Journal Info:
Nlm Unique ID:  9711057     Medline TA:  Int J Med Inform     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  192-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Drug Prescriptions / standards*,  statistics & numerical data*
Humans
Language
Medical Order Entry Systems / standards*
Medication Errors / statistics & numerical data*
Telefacsimile*
Comments/Corrections
Comment In:
Int J Med Inform. 2014 Aug;83(8):601-3   [PMID:  24862892 ]
Int J Med Inform. 2014 Aug;83(8):604   [PMID:  24880918 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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