Related Experiment Video
Updated: Jul 5, 2026
Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
A risk analysis method to evaluate the impact of a computerized provider order entry system on patient safety
Pascal Bonnabry1, Christelle Despont-Gros, Damien Grauser
1Pharmacy, University Hospitals of Geneva, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. Pascal.Bonnabry@hcuge.ch
Objectives:
Quantitative evaluation of safety after the implementation of a computerized provider order entry (CPOE) system, stratification of residual risks to drive future developments.
Design:
Comparative risk analysis of the drug prescription process before and after the implementation of CPOE system, according to the Failure Modes, Effects and Criticality Analysis (FMECA) method.
Measurements:
The failure modes were defined and their criticality indices calculated on the basis of the likelihood of occurrence, potential severity for patients, and detection probability. Criticality indices of handwritten and electronic prescriptions were compared, the acceptability of residual risks was discussed. Further developments were proposed and their potential impact on the safety was estimated.
Results:
The sum of criticality indices of 27 identified failure modes was 3813 for the handwritten prescription, 2930 (-23%) for CPOE system, and 1658 (-57%) with 14 enhancements. The major safety improvements were observed for errors due to ambiguous, incomplete or illegible orders (-245 points), wrong dose determination (-217) and interactions (-196). Implementation of targeted pop-ups to remind treatment adaptation (-189), vital signs (-140), and automatic edition of documents needed for the dispensation (-126) were the most promising proposed improvements.
Conclusion:
The impact of a CPOE system on patient safety strongly depends on the implemented functions and their ergonomics. The use of risk analysis helps to quantitatively evaluate the relationship between a system and patient safety and to build a strategy for continuous quality improvement, by selecting the most appropriate improvements to the system.
Related Concept Videos
01:18Guidelines and Strategies for Safe Computer Charting
Maintain Confidentiality and Security:
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
01:26Types of Reports III: Telephone and Verbal Reports
Here's an overview of each type:
Telephone Orders
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:21Methods of Documentation III: PIE
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...