Our objective is to determine the effects of electronic prescribing on medication safety including medication errors, near misses and preventable adverse drug events in the ambulatory setting. Study design will be a longitudinal evaluation of errors early after implementation and after sustained use.

We will compare the effects of different vendor-based electronic prescribing systems on ambulatory medication safety in various settings, including rural and underserved areas and determine the effects of electronic prescribing systems on ambulatory medication safety over time.

Inclusion Criteria:

• >=0.75 FTE providers

Exclusion Criteria:

• <0.75 FTE providers

Our study will take place in 2 NYS communities. We will select 2 communities in order to assemble a study population with the following characteristics: use of at least 2 different vendor-based systems, different implementation times (with some communities being early adopters and others experienced users), and inclusion of urban underserved and federally defined rural areas.

We will select the following 2 communities/organizations: the community health centers implementing electronic prescribing with the New York City Department of Health (NYC DOH) and the Taconic Health Information Network and Community (THINC) in the Hudson Valley of New York. Both communities have expressed their interest in participating in this study.