Table 2. Major categories and subcategories of the Technology-Related Error Mechanism (TREM) classification.
| 1. Incorrect system configuration or system malfunction | |
| Errors within the system. | |
| 1.1 | System malfunction |
| 1.2 | System contains incorrect order sentence* or other incorrect configuration |
| 1.3 | Limitation in system functionality |
| 2. Opening or using the wrongpatientrecord | |
| Errors that occur when a prescriber uses an incorrect patient record. May include mistyping a medical record number or name, selecting an incorrect patient from a list, inadvertently navigating to a previously opened record or accessing a terminal that already has a record opened by another user. | |
| 3.Selection errors | |
| Errors that occur when any element during prescribing is selected incorrectly from preprogrammed options presented by the system, for example, from a drop-down menu. | |
| 3.1 | Selection errors when ordering |
| 3.2 | Selection errors when constructing or editing an order |
| 4.Construction errors | |
| Errors that occur when constructing an order or typing free text, rather than selecting from drop-down lists or editing order sentences. | |
| 5.Editing errors | |
| Errors that occur when editing (or not editing) a selected prepopulated order sentence or existing order (that are not selection errors or construction errors). | |
| 5.1 | Editing errors (general) |
| 5.2 | Editing errors that occur when using the dose calculator |
| 5.3 | Editing errors that occur when correcting a previous TRE |
| 5.4 | Editing errors that occur when the default time/date are not changed |
| 5.5 | Editing errors that occur when misusing order actions on existing orders |
| 6.Errors that occur when using workflows that differ from a paper-based system | |
| 6.1 | Updated medication profile, active workspace or medication chart not viewed prior to ordering |
| 6.2 | Future order is not activated, or a planned/pending future order or current activated order is not viewed |
| 6.3 | Misuse of actions when ordering discharge or outpatient prescriptions, or when ordering from medication history or using medication reconciliation functionality |
| 6.4 | Errors when using tasks and reminders |
| 6.5 | Other |
| 7.Contributing factor: use of hybrid systems | |
| Errors that occur when two different systems are used for prescribing including some prescribing remaining on paper medication charts or the use of different electronic systems. Note: This category most commonly co-occurs with another mechanism. | |
| 7.1 | Errors occurring during initial system rollout (transition from paper to electronic) |
| 7.2 | Errors occurring during downtime |
| 7.3 | Errors occurring when paper charts are used for some prescribing |
| 7.4 | Errors occurring when different electronic systems operate within the same hospital |
Note: There may be more than one underlying mechanism for one prescribing error. Grey highlights are the categories/subcategories that were in the original classification; some original subcategories were combined.
*
An order sentence is a prewritten prescription sentence or template, which is based on the most common options prescribed for a medication and indication.