Computerized Physician Order Entry Systems and Medication Errors

Hickory, NC - Hospitals have started widely using Computerized Physician Order Entry Systems (CPOE) to reduce medication errors. Published studies show that CPOE reduces the medication errors up to 81% (Source: JAMA). However, CPOE still facilitates medication errors and the research is focusing on how to identify and quantify the role of CPOE in facilitating prescription error risks.

The Agency for Healthcare and Research and Quality (AHRQ) supported a research that was conducted in a large urban hospital and focuses on clinicians' experience in using the CPOE system.

This study - published on March 9 issue of Journal of American Medical Association - showed that 22 types of medication error risks were found, which included fragmented CPOE displays (that prevent a coherent view of patients' medication), pharmacy inventory displays mistaken dosage guidelines and ignored antibiotic renewal notices placed on paper charts rather than in the CPOE system.

Some other findings of errors are:

• Nurses are often unable to enter timely information on the computer due to the patient load.

• Computer Downtime

• A wrong file selection by clinicians

• Patients information is not synthesized on a single screen.

• Staff may look to the CPOE for minimal effective dosage for medication, but the system may only reflect dosage sizes that are available at the pharmacy.

In the process of integrating health information technology products into the health care setting and ensuring the proper usage of the product to improve the quality of care this is a step forward. "It also shows the need for early testing of products by both product designers and purchasers, as well as ongoing refinement and improvement in the products themselves as medical and other staff interact with them," says AHRQ director Dr. Clancy, M.D.

Many medical and risky errors occur frequently in a leading CPOE system. As the CPOE systems are widely regarded and implemented, clinicians and hospitals must attend to errors that these systems may cause in addition to errors that they prevent.

Sources: AHRQ, JAMA

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