Most unsafe medication orders entered into various commercial computerized provider order entry systems were accepted, with no alerts being issued.
BMJ Qual Saf. 2015 Jan 16; [Epub ahead of print].
Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems.
Schiff GD, Amato MG, Eguale T, et al. BMJ Qual Saf. 2015 Jan 16; [Epub ahead of print].
This study used a two-stage approach to analyze the effectiveness of computerized provider order entry(CPOE) at preventing medication errors in real-world settings. The investigators analyzed data from theMEDMARX database in order to identify the types of medication errors caused by computerized order entry. From these data, the researchers developed 21 examples of problematic orders and tested whether they could be entered in a range of commercial CPOE systems. The majority of orders were entered successfully and quickly, without the CPOE system generating any alerts or requiring clinicians to use only minor workarounds to enter the order. Even when the CPOE system did generate an alert, these could generally be overridden by clinicians without changing the order. The study findings mirror those of a prior simulation study and highlight the importance of real-world usability testing for health information technology. Although CPOE systems have been shown to reduce prescribing errors, this study's results indicate that the safety benefits of CPOE may not be achieved without careful implementation and ongoing evaluation.
Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review.
Kaushal R, Shojania KG, Bates DW. Arch Intern Med. 2003;163:1409-1416.
Just what the doctor ordered. Review of the evidence of the impact of computerized physician order entry system on medication errors.
Shamliyan TA, Duval S, Du J, Kane RL. Health Serv Res. 2008;43:32-53.
Designing decision support for insulin ordering in a computerized provider order entry system.
Wright L, Feldott CC, Hargrove FR. Hosp Pharm. 2007;42:158–161.
STUDYView all related resources...
Medication-error reporting and pharmacy resident experience during implementation of computerized prescriber order entry.
Weant KA, Cook AM, Armitstead JA. Am J Health Syst Pharm. 2007;64:526-530.