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Implementing computerized provider order entry with an existing clinical information system.

William M Barron1, R Lawrence Reed, Sean Forsythe

  • 1Loyola University Medical Center, Maywood, Illinois, USA. wbarron@lumc.edu

Joint Commission Journal on Quality and Patient Safety
|November 9, 2007
PubMed
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Implementing computerized provider order entry (CPOE) significantly reduced transcription errors by 97% and pharmacist workload. This demonstrates CPOE

Area of Science:

  • Health Informatics
  • Clinical Systems Implementation
  • Medical Error Reduction

Background:

  • Computerized Provider Order Entry (CPOE) implementation faces numerous barriers.
  • Benefits of older CPOE systems in hospitals are not fully understood.

Purpose of the Study:

  • To assess the impact of implementing an existing CPOE system on medication errors and workflow.
  • To evaluate the feasibility and benefits of CPOE in a large health system.

Main Methods:

  • A project to implement CPOE for hospitalized patients' medications was initiated in 2000.
  • Workflow impact was analyzed, hardware was ensured, and input screens were customized.
  • A formal education and communication plan was used to manage change.

Related Experiment Videos

Main Results:

  • Full CPOE implementation took 20 months.
  • Transcription-related errors decreased by 97% (72.4 to 2.2 per month).
  • Prescribing errors initially increased by 22% but ultimately decreased by 47% from baseline.

Conclusions:

  • Existing CPOE systems offer an affordable intermediate step toward advanced systems.
  • CPOE implementation can lead to significant reductions in medication transcription errors.
  • Careful planning and user customization are key to successful CPOE adoption.