Objectives: This study describes a computer simulation model that has been developed to explore organizational changes required to improve patient safety based on a medication error reporting system. Methods: Model parameters for the simulation model were estimated from data submitted to the MEDMARX medication error reporting system from 570 healthcare facilities in the U.S. The model

Background and purpose: Information technology such as electronic medical records (EMRs), electronic prescribing and decision support systems are recognized as essential tools in Europe, the U.S., Canada, Australia, and New Zealand. But significant barriers impede widescale adoption of these tools, especially EMR systems. Objectives: The objectives of this study were to investigate the present status of information technology in health care, the perceived benefits and barriers by primary care physicians. Methods: Literature analysis and survey data from primary care physicians on adoption of information technology are reviewed. Results: The U.S. trails European countries as well as Canada, Australia and New Zealand in the use of information technology in primary care. The results of the study indicate that physicians in general perceive benefits to information technology, but also cite major barriers to its implementation in their practices. These barriers include lack of access to capital by health care providers, complex systems and lack of data standards that permit exchange of clinical data, privacy concerns and legal barriers. Conclusions: Overcoming these barriers will require subsidies and performance incentives by payers and government; certification and standardization of vendor applications that permit clinical data exchange; removal of legal barriers; and greater security of medical data to convince practitioners and patients of the value of EMRs.

Patient safety is a critical issue in health care. The Institute of Medicine [1] estimates up to 98,000 hospitalized patients die annually as a result of medical error. Nurses serve as a hospital unit