Computerized Physician Order Entry Systems: The Right Prescription?

Policymakers increasingly urge the use of information technology to improve the quality and efficiency of health care. In particular, computerized physician order entry (CPOE) is emphasized for its ability to reduce prescribing errors inherent in paper-based systems. This Issue Brief summarizes research that sounds a cautionary note about the potential for computerized systems to facilitate medication errors, as well as reduce them

Role of Computerized Physician Order Entry Usability in the Reduction of Prescribing Errors

Some hospitals have implemented computerized physician order entry (CPOE) systems to reduce the medical error rates. However, research in this area has been very limited, especially regarding the impact of CPOE use on the reduction of prescribing errors. Moreover, the past studies have dealt with the overall impact of CPOE on the reduction of broadly termed "medical errors", and they have not specified which medical errors have been reduced by CPOE. Furthermore, the majority of the past research in this field has been either qualitative or has not used robust empirical techniques. This research examined the impacts of usability of CPOE systems on the reduction of doctors' prescribing errors. Methods: One hundred and sixty-six questionnaires were used for quantitative data analyses. Since the data was not normally distributed, partial least square path modelling-as the second generation of multivariate data analyses-was applied to analyze data. Results: It was found that the ease of use of the system and information quality can significantly reduce prescribing errors. Moreover, the user interface consistency and system error prevention have a significant positive impact on the perceived ease of use. More than 50% of the respondents believed that CPOE reduces the likelihood of drug allergy, drug interaction, and drug dosing errors thus improving patient safety. Conclusions: Prescribing errors in terms of drug allergy, drug interaction, and drug dosing errors are reduced if the CPOE is not error-prone and easy to use, if the user interface is consistent, and if it provides quality information to doctors

Does Computerized Physician Order Entry Reduce Medical Errors?

Introduction: Computerized Physician Order Entry (CPOE) is a system that allows physicians to electronically order patient services. The services that can be ordered, but are not limited to include: prescriptions, labs, x-rays, and referrals. Adopting CPOE will eliminate the use of paper orders with illegible hand writing. The purpose of this research project was to examine the cause of medical errors and to determine if adopting a CPOE system would be an effective solution to this problem. Results: The results of this study show that CPOE can reduce medical errors and adverse drug events significantly. CPOE coupled with other systems has shown a positive outcome preventing medical errors. Some major barriers of adoption and implementation of a CPOE system is the cost associated with it and older physicians being stuck in old ways of practicing medicine. Discussion/Conclusion: Adoption and implementation of CPOE has been growing in recent years with the HITECH Act of 2009. While preventable medical errors and ADE’s continue to increase; this study will show that adopting a CPOE system can reduce medical errors and ADE’s

UNM Medicine Grand Rounds Presentation: Medical Informatics —- What is the Evidence?

Electronic physician order entry and medical records systems are being installed in health care settings throughout the country. Many physicians and other providers may not be aware of the science behind the potential benefits of using these new technologies. This talk will provide a basic defintion of the field of medical informatics and review the basic science behind electronic physician order entry and what are some realistic potentials for its future use.https://digitalrepository.unm.edu/hslic-posters-presentations/1032/thumbnail.jp

Explaining Physician Technology Acceptance of Computerized Physician Order Entry (CPOE)

This study explores factors relating to physicians acceptance of technology for computerized physician order entry (CPOE. Given the complexity of the healthcare industry and its unique occupational dynamics, the Davis’ Technology Acceptance Model (TAM) alone may not be an appropriate methodology for explaining technology acceptance as it applies to medical practitioners. Along with perceived ease of use and perceived usefulness, the constructs of the TAM, we posit that behavioral constructs also influence physicians’ acceptance of technology. These include the physician work values of achievement, autonomy/independence, relationships and recognition, and physician subjective norms and perceived behavioral control. In this paper, we report findings which provide preliminary empirical support for the theory that work values, norms, and control also influence technology acceptance

The vulnerabilities of computerized physician order entry systems: a qualitative study

Objective To test the vulnerabilities of a wide range of computerized physician order entry (CPOE) systems to different types of medication errors, and develop a more comprehensive qualitative understanding of how their design could be improved. Materials and Methods The authors reviewed a random sample of 63 040 medication error reports from the US Pharmacopeia (USP) MEDMARX reporting system where CPOE systems were considered a “contributing factor” to errors and flagged test scenarios that could be tested in current CPOE systems. Testers entered these orders in 13 commercial and homegrown CPOE systems across 16 different sites in the United States and Canada, using both usual practice and where-needed workarounds. Overarching themes relevant to interface design and usability/workflow issues were identified. Results CPOE systems often failed to detect and prevent important medication errors. Generation of electronic alert warnings varied widely between systems, and depended on a number of factors, including how the order information was entered. Alerts were often confusing, with unrelated warnings appearing on the same screen as those more relevant to the current erroneous entry. Dangerous drug-drug interaction warnings were displayed only after the order was placed rather than at the time of ordering. Testers illustrated various workarounds that allowed them to enter these erroneous orders. Discussion and Conclusion The authors found high variability in ordering approaches between different CPOE systems, with major deficiencies identified in some systems. It is important that developers reflect on these findings and build in safeguards to ensure safer prescribing for patients