Medication safety and electronic decision support

Medication safety and electronic decision support

Medication error and inappropriate medication therapy are two of the oldest, most costly and least tractable safety problems which health systems face. Information technology has the potential to make medication management safer and more effective. With that expectation, health systems worldwide are making vast investments in information technology. Our research is investigating the ways in which information technology can reduce medication errors and support improved medication therapy decisions and outcomes in hospital and residential aged care facilities.

Our research also aims to understand and improve the fit between users and their work environment to optimise safety, productivity, and efficiency through the development of electronic decision support tools. We apply a broad range of methods, including field observations, interviews and focus groups, simulation, and system logs to understand how information technology is used by clinicians, and identify well-designed and poorly designed system features.

Stream team members

Professor Johanna Westbrook
Professor and Director

Associate Professor Ling Li

Associate Professor

Dr Magdalena Raban

Senior Research Fellow

Dr Mirela Prgomet

Research Fellow

Dr Virginia Mumford

Research Fellow

Dr Kim Lind

Research Fellow

Dr Rae-Anne Hardie

Research Fellow

Dr Amy Nguyen

Research Fellow

Dr Peter Gates

Postdoctoral Research Fellow

Dr Rachel Urwin

Research Assistant

Ms Erin Fitzpatrick
Research Officer

Ms Alison Merchant
Research Officer

Ms Claire Maddox
Research Assistant


Stream coordinator

Dr Magda Raban
Ph: 02 9850 2433

News and media

Professor Johanna Westbrook awarded the National Health and Medical Research Council (NHMRC) Elizabeth Blackburn Investigator Grant Award

The outstanding leadership of Macquarie University Professor Johanna Westbrook has been recognised with the announcement of the National Health and Medical Research Council (NHMRC) Elizabeth Blackburn Investigator Grant Award (Leadership in Health Services Research) at the NHMRC Research Excellence Awards in Canberra last night.

Professor Westbrook is internationally recognised for her research evaluating the effects of information and communication technology in healthcare and is the Director of the Centre for Health Systems and Safety Research at the Australian Institute of Health Innovation.

The Elizabeth Blackburn Investigator Grant Award recognises the highest-ranking woman in the area of health services, determined by a peer review process. Read more.

Drop in medication errors at children’s hospital with new e-system

Early results from the Delivering safe and effective care for children project have recently gained media attention. Prof Johanna Westbrook provides background here and here .

30th Medical Informatics Europe (MIE) conference, 2020

Dr Valentina Lichtner’s submissions to 30th Medical Informatics Europe conference (MIE) have been accepted. Valentina will present in Geneva, 28/4-1/5/2020.

  • A poster: Lichtner, V, Prgomet, M, Franklin, BD, Westbrook, JI, The ‘back office’ of a dispensing cabinet: technology and work contributing to medication safety
  • A workshop: Lichtner, V, Pelayo, S, Westbrook, JI, Drifting into medication errors with automated dispensing cabinets: how to prevent it? A workshop for a medical informatics approach
  • A workshop: Marcilly, R, Kuziemsky, C,  Nohr, C, Peute, L, Lichtner, V, Ethics Reviews and Human and Organizational Factors’ Research in European Countries: a panel from the HOFMI working group
Prof Johanna  Westbrook awarded $2.5M of NHMRC funding for research on optimising eMM

Prof Johanna Westbrook was awarded a National Health and Medical Research Council Investigator Grant worth $2.5 million titled “Delivering safe and effective medication management technology now and for the future”.

There is little robust evidence to guide massive investments in electronic medication management (eMM) systems in hospitals. This innovative program of work will generate the new evidence, policy and practice urgently needed to optimise eMM systems to ensure they save lives and improve health outcomes, now and in future.

Dr Valentina Lichtner presents an AIHI Seminar, 10 October 2019

Dr Valentina Lichtner presented her work on “Ultra-safe, collective mindfulness and electronic medication management systems in paediatric oncology” at the AIHI Seminar Series, Macquarie University. Dr Lichtner’s presentation discussed the challenges of operating ultra-safe models of safety; how adherence to protocol and management of risks is sometimes achieved through collective mindfulness practices typical of high-reliability organisations; and the three levels of awareness (situation, team and organisational) that make technology work.

Dr Lichtner is a Marie-Curie visiting fellow at the Centre for Health Systems and Safety Research where she has been working with the Medication Safety and Decision Support team.

36th International Society for Quality in Health Care International Conference, Cape Town, 20-23 October, 2019

Prof Johanna Westbrook, Dr Peter Gates and Dr Kim Lind represented the Medication Safety and Electronic Decision Support team at the ISQua International Conference in Capetown in October 2019. They delivered five presentations and posters. Read more.

Selected publications

  1. Raban MZ, Lind K. Nudging: can letters to GPs reduce antipsychotics in aged care? MJA Insight. 2020; 10 Feb.
  2. Baysari MT, Raban MZ. The safety of computerised prescribing in hospitals. Australian Prescriber. 2019; 42(4):136-8.
  3. Westbrook JI, Lichtner V. Why is measuring the effects of information technology on medication errors so difficult? The Lancet Digital Health; 2019;1(8):PE378-E379
  4. Baysari MT, Zheng WY, Tariq Am, Heywood M, Scott G, Li L, Van Dort BA, Rathnayake K, Day RO, Westbrook JI. An experimental investigation of the impact of alert frequency and relevance on alert dwell time. International Journal of Medical Informatics; 2020;133:104027.
  5. Raban MZ, Gasparini C, Li L, Baysari MT, Westbrook JI. Effectiveness of interventions targeting antibiotic use in long-term aged care facilities: a systematic review and meta-analysis. BMJ Open. 2020; 10:e028494.
  6. Gates P, Baysari MT, Gazarian M, Raban MZ, Meyerson S, Westbrook JI. Prevalence of medication errors among paediatric inpatients: systematic review and meta-analysis. Drug Safety. 2019; 42(11):1329-1342.
  7. Gates P, Baysari MT, Mumford V, Raban MZ, Westbrook JI. Standardising the classification of harm associated with medication errors: The Harm Associated with Medication Error Classification (HAMEC). Drug Safety. 2019; 42(8):931-939.
  8. Lichtner V, Baysari MT, Gates P, Dalla-Pozza L, Westbrook JI. Medication safety incidents in paediatric oncology after electronic medication management system implementation. European Journal of Cancer Care. 2019; 28:e13152.
  9. Westbrook JI, Li L, Shah S, Lehnbom E, Prgomet M, Schofield B, Cresswell K, Slee A, Coleman J, McCloughan L, Sheikh A. A cross-country time and motion study to measure the impact of electronic medication management systems on the work of hospital pharmacists in Australia and England. International Journal of Medical Informatics. 2019; 129: 253-259.
  10. Lind KE, Raban MZ, Georgiou A, Westbrook JI. NSAID use among residents in 68 residential aged care facilities 2014 to 2017: An analysis of duration, concomitant medication use, and high-risk conditions. Pharmacoepidemiology and Drug Safety. 2019; 28(11):1480-1488.
  11. Lind KE, Raban MZ, Georgiou A, Westbrook JI. Duration of antipsychotic medication use by aged care facility residents with dementia. Alzheimer Disease and Associated Disorders. 2019; 33(4):331-338.
  12. Lind KE, Gray LC, Raban MZ, Georgiou A, Westbrook JI. Antidementia medication use by aged care residents with dementia. International Journal of Geriatric Psychiatry. 2019; 34(7):1029-1040.
  13. Raban MZ, Walter SR, Pont LG, Cheung L, Strumpman D, Westbrook JI. The potential impact of an electronic medication management system on safety critical prescribing errors in an emergency department. Journal of Pharmacy Practice and Research. 2019; 49:108-115.
  14. Pont L, Raban MZ, Jorgensen ML, Georgiou A, Westbrook JI. Leveraging new information technology to monitor medicine use in 71 residential aged care facilities: variation in polypharmacy and antipsychotic use. International Journal for Quality in Health Care. 2018; 30(10):810-16.
  15. Mumford V, Baysari MT, Kalinin D, Raban MZ, McCullagh C, Karnon J, Westbrook JI. Measuring the financial and productivity burden of paediatric hospitalisation on the wider family network. Journal of Paediatrics and Child Health. 2018; 54(9):987-996.
  16. Westbrook JI, Li L, Hooper TD, Raban MZ, Middleton S, Lehnbom EC. Effectiveness of a ‘Do not interrupt’ bundled intervention to reduce interruptions during medication administration: a cluster randomised controlled feasibility study. BMJ quality & safety 2017; 26(9):734-42.
  17. Koyama AK, Maddox CS, Li L, Bucknall T, Westbrook JI. Effectiveness of double checking to reduce medication administration errors: a systematic review. BMJ Qual Saf. 2019.
  18. Baysari MT, Zheng WY, Li L, Westbrook J, Day RO, Hilmer S, Van Dort BA, Hargreaves A, Kennedy P, Monaghan C, Doherty P, Draheim M, Nair L, Samson R. Optimising computerised decision support to transform medication safety and reduce prescriber burden: study protocol for a mixed-methods evaluation of drug-drug interaction alerts. BMJ Open. 2019; 9(8):e026034.
  19. Alexander GL, Georgiou A, Siette J, Madsen R, Livingstone A, Westbrook J, Deroche C. Exploring information technology (IT) sophistication in New South Wales residential aged care facilities. Aust Health Rev. 2019.
  20. Page N, Baysari MT, Westbrook JI. Selection and use of decision support alerts in electronic medication management systems in Australian hospitals: a survey of implementers. Journal of Pharmacy Practice and Research. 2019; 49(2):142-9.
  21. Westbrook JI, Baysari MT. Nudging hospitals towards evidence-based decision support for medication management. Med J Aust. 2019; 210 Suppl 6:S22-S4.
  22. Baysari MT, Hardie RA, Lake R, Richardson L, McCullagh C, Gardo A, Westbrook J. Longitudinal study of user experiences of a CPOE system in a pediatric hospital. Int J Med Inform. 2018; 109:5-14.
  23. Page N, Baysari MT, Westbrook JI. A systematic review of the effectiveness of interruptive medication prescribing alerts in hospital CPOE systems to change prescriber behavior and improve patient safety. Int J Med Inform. 2017; 105:22-30.

Content owner: Australian Institute of Health Innovation Last updated: 16 Jun 2020 3:06pm

Back to the top of this page