Developing a Safety Case for Electronic Prescribing

It is now recognised that Health IT systems can bring benefits to healthcare, but they can also introduce new causes of risks that contribute to patient harm. This paper focuses on approaches to modelling and analysing potential causes of medication errors, particularly those arising from the use of Electronic Prescribing. It sets out a systematic way of analysing hazards, their causes and consequences, drawing on the expertise of a multidisciplinary team. The analysis results are used to support the development of a safety case for a large-scale Health IT system in use in three teaching hospitals. The paper shows how elements of the safety case can be updated dynamically. We show that it is valuable to use the dynamically updated elements to inform clinicians about changes in risk, and thus prompt changes in practice to mitigate the risks.