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Effects of computerized physician order entry on prescribing practices.
J M Teich1, P R Merchia, J L Schmiz
1Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. jteich@harvard.edu
Archives of Internal Medicine
|October 12, 2000
Summary
Computerized physician order entry (CPOE) systems significantly improve prescribing practices by providing real-time feedback and guidelines. This technology enhances medication selection, dosing accuracy, and adherence to recommended frequencies, leading to better patient care.
Area of Science:
- Health Informatics
- Clinical Pharmacy
- Medical Quality Improvement
Background:
- Computerized order entry systems offer potential benefits in error prevention, care quality enhancement, and cost reduction.
- These systems provide physicians with real-time feedback and suggestions during order entry.
Purpose of the Study:
- To assess the impact of an inpatient computerized physician order entry (CPOE) system on physician prescribing practices.
- To evaluate the effectiveness of CPOE in influencing medication selection, dosing, and frequency adherence.
Main Methods:
- A time series analysis was conducted at an urban academic medical center.
- Physicians utilized a CPOE system that displayed drug use guidelines, alternatives, and dosing suggestions.
Main Results:
- Computerized guidelines increased the use of recommended drugs (e.g., nizatidine) from 15.6% to 81.3%.
- Dose selection menus reduced dose variability by 11% and decreased excessive doses from 2.1% to 0.6%.
- Recommended frequency displays improved adherence for ondansetron hydrochloride from 6% to 75%, and suggested prophylaxis use increased from 24% to 47%.
Conclusions:
- Computerized physician order entry (CPOE) is a highly effective tool for optimizing physician prescribing behaviors.
- The observed improvements in prescribing practices were sustained at 1- and 2-year follow-up analyses.