Closed loop medication process – the electronic verification of the 5 rights

Closed loop medication process – the electronic verification of the 5 rights

This blog article was published 17.05.2018 and thoroughly updated 1.11.2022.

The five rights – the right patient, the right medicine, the right dose, the right time and the right route. Studies1 show that medication errors can be reduced by taking advantage of closed loop medication process and verifying the “five rights” electronically.

Medication errors are one of the leading causes of adverse events and patient injuries in the world, and a common reason behind hospital mortality. More than half of medication errors occur when the medication is administered.2 Medication errors may be caused by, e.g., negligence, fatigue, or insufficient pharmacological information.

Closed loop medication process supports cross-checking the right patient, medicine, and prescription using digital technology.

Implementing a safe medication process

In the closed loop medication process, the whole medication cycle (prescribing, processing, dispensing and administering) is electronic and automated as far as possible. No data is transferred on paper at any point.

Achieving the desired workflow in the closed loop medication process often requires an eco-system of integrated solutions and technologies to work together. The ultimate goal is to eliminate information breaks and minimise human errors.

Closed loop medication process can be achieved through seamless integrations with different systems.”

1.)   Electronic Health Record (EHR)

Medication is prescribed electronically in a structured format. Handwritten prescriptions are eliminated, and the number of errors caused by misreading illegible handwriting is reduced. The clinician also receives information on safety factors, like allergies the patient may have, immediately while prescribing the medication.

2.)   Pharmacy system

The system automatically checks for safety factors, contraindications and the appropriate dosage of the electronic prescription. The medicine substitute dispensed is also saved in the EHR and, at the administration stage, precisely the correct brand name of the medicine is shown.

3.)   Automated dispensing cabinet

The automated dispensing cabinet guides the nurse to dispense the right medicine for the right patient. The bar-coded medicine packages are documented and machine-sealed into sachets.

4.)   Mobile solution

The electronically identified nurse checks the compatibility of the medicine, dose, time, route and the patient by scanning the patient wristband and the medicine sachet. The entry for each administered medication is saved into the EHR at once.


1. Truitt et al. (2016). Effect of the Implementation of Barcode Technology and an Electronic Medication Administration Record on Adverse Drug Events. Hosp Pharm.

2. Elliott et al. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England.BMJ Qual Saf.

Download a concise 15-page eBook that brings together facts and figures on medication administration errors and describes the closed loop medication process.


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