Optimized Computerized Order Entry can Reduce Errors in Electronic Prescriptions and Associated Pharmacy Calls to...

Area of Science:

• Health Informatics
• Clinical Pharmacy
• Medical Error Reduction

Background:

• Electronic prescribing is standard following university-wide EMR implementation.
• Computerized provider order entry (CPOE) systems are central to electronic prescribing workflows.

Purpose of the Study:

• To evaluate if CPOE optimization reduces electronic prescription errors.
• To assess if optimized CPOE decreases pharmacist interventions, specifically "call to clarify" (CTC) instances.
• To perform a secondary cost analysis of optimization changes.

Main Methods:

• Implemented inline validation messages in CPOE for missing provider/pharmacy, DEA non-compliance, character limits, and unclear instructions.
• Analyzed 602 prescriptions (301 pre-optimization, 301 post-optimization) for errors requiring CTC.
• Statistically compared error rates before and after CPOE optimization.

Main Results:

• Prescription error rates decreased from 20.27% to 12.96% after CPOE optimization, a statistically significant reduction (p<0.05).
• Estimated cost savings of $76 per 100 prescriptions were identified, combining pharmacist and physician time costs.

Conclusions:

• CPOE optimization effectively reduces electronic prescribing errors and the frequency of pharmacist CTCs.
• This study highlights specific CPOE modifications that enhance prescription accuracy and potentially lower healthcare costs.