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Exploring the unintended consequences of computerized physician order entry.
Joan S Ash1, Dean F Sittig, Richard Dykstra
1Oregon Health & Science University, School of Medicine, Portland, OR 97239-3098, USA. ash@ohsu.edu
Studies in Health Technology and Informatics
|October 4, 2007
Summary
Computerized physician order entry (CPOE) can cause unintended consequences. This study identified nine types, surveyed hospitals, and developed strategies and a toolkit to manage these adverse events.
Area of Science:
- Health Informatics
- Medical Informatics
- Patient Safety
Background:
- Computerized Physician Order Entry (CPOE) systems are widely adopted in healthcare.
- The implementation of CPOE can lead to unintended adverse consequences.
- Understanding and mitigating these consequences is crucial for patient safety and system efficiency.
Purpose of the Study:
- To identify and categorize unintended consequences of CPOE.
- To investigate how hospitals recognize and manage these consequences.
- To develop strategies and a toolkit for addressing CPOE-related adverse events.
Main Methods:
- A mixed methods approach was employed over a three-year research project.
- Analysis of 380 documented examples of unintended adverse consequences.
- A national survey of U.S. hospitals regarding CPOE consequence management.
- Expert panel consultation to identify management strategies.
Main Results:
- Nine major types of unintended adverse consequences from CPOE were identified and categorized.
- The study revealed diverse hospital approaches to recognizing and managing these consequences.
- Effective strategies for managing unintended adverse consequences were identified.
Conclusions:
- Hospitals face significant unintended consequences from CPOE implementation.
- A proactive approach involving expert-validated strategies and a practical toolkit is essential for managing CPOE-related risks.
- The findings provide a framework for improving CPOE safety and effectiveness.
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