The Effect of Computerized Physician Order Entry on Medication Errors and Adverse Drug Events in Pediatric Inpatients

King, W. James; Paice, Naomi; Rangrej, Jagadish; Forestell, Gregory J; Swartz, Ron

doi:10.1542/peds.112.3.506

Cited by 238 publications

(164 citation statements)

References 22 publications

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] There can be unintended consequences as well, however, [15][16][17][18][19][20][21][22][23][24] and it is likely that fear of adverse unintended consequences is impeding the diffusion of CPOE throughout hospitals in the U.S. [25][26][27][28][29] The unintended consequences of CPOE are especially intriguing because they can surprise implementers. Adverse unintended consequences unfortunately can become impediments to health care quality.…”

Section: Introductionmentioning

confidence: 99%

The Extent and Importance of Unintended Consequences Related to Computerized Provider Order Entry

Ash

Sittig

Poon

et al. 2007

Journal of the American Medical Informatics Association

425

266

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A b s t r a c t Background:Computerized provider order entry (CPOE) systems can help hospitals improve health care quality, but they can also introduce new problems. The extent to which hospitals experience unintended consequences of CPOE, which include more than errors, has not been quantified in prior research.Objective: To discover the extent and importance of unintended adverse consequences related to CPOE implementation in U.S. hospitals.Design, Setting, and Participants: Building on a prior qualitative study involving fieldwork at five hospitals, we developed and then administered a telephone survey concerning the extent and importance of CPOE-related unintended adverse consequences to representatives from 176 hospitals in the U.S. that have CPOE. Measurements:Self report by key informants of the extent and level of importance to the overall function of the hospital of eight types of unintended adverse consequences experienced by sites with inpatient CPOE. Results:We found that hospitals experienced all eight types of unintended adverse consequences, although respondents identified several they considered more important than others. Those related to new work/more work, workflow, system demands, communication, emotions, and dependence on the technology were ranked as most severe, with at least 72% of respondents ranking them as moderately to very important. Hospital representatives are less sure about shifts in the power structure and CPOE as a new source of errors. There is no relation between kinds of unintended consequences and number of years CPOE has been used. Despite the relatively short length of time most hospitals have had CPOE (median five years), it is highly infused, or embedded, within work practice at most of these sites. Conclusions:The unintended consequences of CPOE are widespread and important to those knowledgeable about CPOE in hospitals. They can be positive, negative, or both, depending on one's perspective, and they continue to exist over the duration of use. Aggressive detection and management of adverse unintended consequences is vital for CPOE success.

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Section: Introductionmentioning

confidence: 99%

The Extent and Importance of Unintended Consequences Related to Computerized Provider Order Entry

Ash

Sittig

Poon

et al. 2007

Journal of the American Medical Informatics Association

425

266

View full text Add to dashboard Cite

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“…King et al (2003) reported that the adoption of computerized prescriber order entry (CPOE), a crucial component of EMRs, decreased medication errors by 40%. Additionally, Bates et al (2001) found that EMR adoption reduced absolute adverse drug events by 70%.…”

Section: Introductionmentioning

confidence: 99%

Health Information Technology and its Effects on Hospital Costs, Outcomes, and Patient Safety

Encinosa

Bae²

2011

INQUIRY

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Underlying many reforms in the Patient Protection and Affordable Care Act (ACA) is the use of electronic medical records (EMRs) to help contain costs. We use MarketScan® claims data and American Hospital Association information technology (IT) data to examine whether EMRs can contain costs in the ACA's reforms to reduce patient safety events. We find EMRs do not reduce the rate of patient safety events. However, once an event occurs, EMRs reduce death by 34%, readmissions by 39%, and spending by $4,850 (16%), a cost offset of $1.75 per $1 spent on IT capital. Thus, EMRs contain costs by better coordinating care to rescue patients from medical errors once they occur.

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“…HIS may also improve health care quality through the use of standardized clinical pathways; e-prescribing systems, which would detect drug interactions; and better and more complete documentation of care [14]. These improved processes are expected to lead to significant reductions in medical errors [20][21]. The automated access of physicians to patient laboratory and other diagnostic results may reduce lost orders and errors due to illegible handwriting, and minimize duplicate orders [22], thus improving health care quality outcomes and efficiency [23].…”

Section: Review Of Literature 21 Hismentioning

confidence: 99%

A Newly Proposed HIS Implementation Success Model for Nursing, using an Electronic Approach for Design

Rezaian¹,

Selamat²,

Yusoff³

2016

IJCA

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Despite the advantages of utilizing hospital information systems (HISs) in nursing care, and their contribution to nursing structures and care processes, the troubling issue of HIS underutilization continues. Low utilization of installed systems has been identified as a major problem in implementing information technology (IT). Unfortunately, nurses have been unwilling to apply technology to healthcare delivery, although they generally have a positive attitude toward computers. In this study, based on the Critical Success Factos (CSFs) and DeLone and McLean's Information Systems success model, an implementation framework, made up of essential elements to guide successful HIS implementation for nursing staff is proposed. This study is among the few that have tested empirically an implementation framework in the developing countries settings, and provides helpful guidelines for hospital managers in planning HIs implementation in such countries. General Terms

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The Effect of Computerized Physician Order Entry on Medication Errors and Adverse Drug Events in Pediatric Inpatients

Abstract: The introduction of a commercially available physician computer order entry system was associated with a significant decrease in the rate of medication errors but not ADEs in an inpatient pediatric population.

Cited by 238 publications

References 22 publications

The Extent and Importance of Unintended Consequences Related to Computerized Provider Order Entry

The Extent and Importance of Unintended Consequences Related to Computerized Provider Order Entry

Health Information Technology and its Effects on Hospital Costs, Outcomes, and Patient Safety

A Newly Proposed HIS Implementation Success Model for Nursing, using an Electronic Approach for Design

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