Impact of Health Information and Medical Device Technologies on Patient Medication Safety and Clinical Decision-Making in Emergency Medicine: A Systematic Review Protocol and Preliminary Evidence Map

Medication errors and preventable adverse drug events remain a leading, largely avoidable source of patient harm, and the emergency department (ED) is among the highest-risk settings owing to time pressure, interruptions, undifferentiated patients, and crowding. Health information technologies (HIT) and medical-device technologies—computerised provider order entry (CPOE), clinical decision support systems (CDSS), barcode-assisted medication administration (BCMA) with electronic medication administration records, automated dosing and dispensing devices, smart infusion systems, and interoperable electronic health records (EHR)—are widely promoted to reduce error and to support clinical decision-making. Evidence specific to emergency medicine remains fragmented across technology types and outcomes, and evaluations from Saudi Arabia and the wider Gulf region are sparse. To specify, in advance, a rigorous protocol for a systematic review of the effect of HIT and medical-device technologies on medication safety and clinical decision-making in the ED, and to present a preliminary evidence map that characterises the current landscape and its gaps. Methods. The review will be reported in line with PRISMA 2020 and this protocol follows PRISMA-P; prospective registration on PROSPERO is intended. Eligibility is framed with a PICO structure: ED patients and clinicians (Population); any HIT or medical-device technology in the medication-use process (Intervention); usual care, manual processes, or an alternative technology (Comparator); and medication-safety outcomes (error and adverse-drug-event rates) plus clinical decision-making outcomes (alert acceptance and override, prescribing appropriateness, and time-to-administration). PubMed/MEDLINE, Embase, CINAHL, Scopus, Cochrane CENTRAL, and IEEE Xplore will be searched alongside regional and grey-literature sources. Screening will be dual and independent in Rayyan or Covidence; risk of bias will be appraised with design-appropriate tools (RoB 2, ROBINS-I, JBI, AMSTAR-2, and EPOC criteria for interrupted time series), and certainty with GRADE. Findings will be synthesised narratively and displayed as an evidence map, with meta-analysis where clinical and statistical homogeneity allow. Preliminary evidence map. A scoping search identified a purposive corpus of fourteen technology-bearing studies (twelve international, two Saudi/GCC-MENA). Evidence concentrated in CPOE/CDSS (n=6) and BCMA/eMAR (n=4); ordering and administration safety were the best-covered outcomes, whereas clinical decision-making outcomes—particularly alert acceptance, override, and alert fatigue—were comparatively under-represented. Regional evaluations were limited to an automated intravenous dosing tool in a Riyadh paediatric ED and a medication-reconciliation intervention, revealing a marked Saudi–global evidence gap that the full review is designed to address. Conclusion. This protocol and preliminary map establish the scope, methods, and knowledge gaps for a systematic review that will inform technology-enabled medication-safety strategy in emergency medicine, with particular relevance to Saudi Arabia's digital-health transformation. Registration. PROSPERO registration is intended prior to formal screening (identifier to be assigned).