Electronic Medication Administration Records (eMar) are noticeably absent from Phase 1 hospital Meaningful Use criteria, although 10% or more of providers are expected to enter orders into the EHR.  If the creators of Meaningful Use criteria sequenced functionality based on patient safety goals we’d expect the eMar to precede or be concurrent with all provider order entry for two primary reasons.

First, an eMar has the potential to prevent more medication errors than CPOE.  While MDs and RNs have similar error rates, fifty percent (50%) of MD errors are intercepted by pharmacy or RNs whereas ninety-eight percent (98%) of RN errors reach the patient.  Second, MDs need easy access to online med administration information, not just medications ordered, in entering new drug protocols or renewing existing orders.

Failure to align eMar with CPOE functionality puts the physician and patient at greater risk of medication and treatment decisions being made without important data.  To access current medication administration information, MDs need to call nursing units if remote or chase down paper MARs if on the nursing unit.  Organizations must consider interrelated clinician workflows in strategizing EHR rollouts and not use Stimulus fund payments criteria and timelines as a yellow brick road.