A hospital is a dangerous place to be. It was recently estimated that approximately a quarter-million Americans die annually from medical errors, putting it as the third leading cause of death in the US [1]. While the numbers are subjected to further debates, the fundamental argument that some medical errors are entirely preventable must not be overlooked.

Indeed, the provision of advanced medical care to patients should not increase the risk of medical errors. Health organizations today offer thousands of life-saving treatments, but the success of which depends heavily upon the support of an efficient health IT system. It is not uncommon that some critically ill patients are put on more than 10 medications, or elderly patients who need multidisciplinary care that span across the entire spectrum of healthcare from nursing homes to critical care units.

Hence, the core competency for a healthcare organization is the capacity in managing complex systems and in ensuring medical errors are caught in time by internal safety checks. In other words, patient safety is secured by minimizing what is known as “system sloppiness” [2].

The seven rights of medication administration

According to figures released by the World Health Organization (WHO), medication errors represent up to 56% of all adverse drug events in hospitals, the cost of which was estimated between €4.5 billion to €22 billion [3,4]. So how do we know what constitutes the right medication administration?

In general, healthcare providers must adhere to the “seven rights” principle of medication administration: right medication, right patient, right dose, right time, right route, right reason, and right documentation. However, the challenge of ensuring adherence is typically underestimated, particularly when patients have a complicated therapy or are receiving care in a chaotic environment.

This brings us back to the importance of having an excellent medication module that could screen for errors while simultaneously minimize the cognitive and mental burden of healthcare providers. Numerous studies have shown that suboptimal healthcare systems are harmful to patient safety and a risk factor to burnout [5]. All these beg the question – why did these systems fail? And the answer is – poor design and unfriendly workflow processes.

The right medication module

A smart medication module or system must be carefully designed to meet the complex needs of the 21st-century hospital, and it must have at least three attributes: (1) User-friendly interface, (2) Comprehensive yet straightforward data visualisation, and (3) Transparency.

The healthcare industry is woefully under-engineered. Too often, physicians have to battle cumbersome computer processes or redundant steps to retrieve or enter information into the system, yet simplicity should be an integral feature of a medication module. Steve Jobs famously demanded that Apple’s users must be able to navigate to any function in three, intuitive clicks. Such insight in the design simplicity is rare, but not impossible in healthcare. COSMIC 3rd generation medication module has extremely simplified UI – with two clicks maximum* to navigate to the needed patient information.

Data storytelling is another crucial but often overlooked element in medication safety. Studies have strongly suggested that integrated data display which centres around the end-users’ needs are associated with better performance, faster and more accurate decision-making, and reduced cognitive requirement [6].

COSMIC medication module has enhanced efficiency for decision-making with an integrated display that is akin to the cockpit of an aeroplane – the pilot has a direct overview to the most relevant information but also has easy access to all other patient information. The medication module will display vital information such any drug-drug interactions, polypharmacy, and crucial patient-related data such as age, pregnancy, allergies, or historical prescription, all in the main display panel.

Lastly, transparency of the system would aid healthcare providers to cross-reference each other’s work and prevent any medication errors from slipping through. When a nurse can review what the doctor is prescribing, there is a good chance that the nurse can pick up any potential issues such as polypharmacy with prescriptions from another doctor, or the nurse could better time dose administration based on the doctor’s rounding time. Transparency is vital for cross-disciplinary cooperation regardless of geographical location and is imperative to ensure the seven rights principle is adhered to at all times.

About Cambio & COSMIC

Cambio is an award-winning and the biggest EHR vendor in Scandinavia with presence in both Sweden, Denmark and the United Kingdom. The COSMIC Medication Module is currently in its 3rd generation, and it is among the most modern and complete medication module in Europe. For more information, please visit www.cambio.dk and email us at DKMarketing@cambio.se.

*when navigating from the “favorite” page


1. Makary MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ 2016;:i2139. doi:10.1136/bmj.i2139

2. Jha A. The Real Cause of Deadly Medical Errors. Sci Am 2016.

3. Kaplan W, Laing R. Priority Medicines for Europe and the World. Geneva: 2004.

4. European Medicines Agency. Tackling medication errors: European Medicines Agency workshop calls for coordinated EU approach. EMA Press Release. 2013.https://www.ema.europa.eu/news/tackling-medication-errors-european-medicines-agency-workshop-calls-coordinated-eu-approach (accessed 2 Nov 2019).

5. Fred HL, Scheid MS. Physician Burnout: Causes, Consequences, and (?) Cures. Texas Hear Inst J 2018;45:198–202. doi:10.14503/THIJ-18-6842

6. Wright MC, Borbolla D, Waller RG, et al. Critical care information display approaches and design frameworks: A systematic review and meta-analysis. J Biomed Informatics X 2019;3:100041. doi:10.1016/j.yjbinx.2019.100041