Does computerized provider order entry reduce prescribing errors for hospital inpatients? A systematic review.

Area of Science:

• Health Informatics
• Patient Safety
• Clinical Pharmacy

Background:

• Previous reviews on Computerized Provider Order Entry (CPOE) and medication errors used inconsistent definitions of 'error'.
• There is a need for focused evidence on CPOE's impact on prescribing errors in hospital inpatients.

Purpose of the Study:

• To evaluate the existing evidence on whether CPOE systems effectively reduce prescribing errors among hospital inpatients.

Main Methods:

• Systematic review of 13 papers (12 studies) published between 1998 and 2007.
• Focused on studies investigating CPOE's impact on prescribing error rates in inpatient settings.

Main Results:

• Nine studies reported significant reductions in prescribing error rates for some or all drug types.
• Minor errors decreased most frequently; however, some studies noted increased duplicate orders and failure to discontinue medications.
• Error severity changes were infrequently examined.

Conclusions:

• The evidence supporting CPOE's effectiveness in reducing prescribing errors is not compelling.
• Current evidence is limited by small sample sizes and study designs.
• Future research requires larger, multi-site, controlled studies with standardized error reporting and investigation into decision support's role.