Effects of Computerized Physician Order Entry on Prescribing Practices

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This is a review of Teich, J. M., Merchia, P. R., Schmiz, J. L., Kuperman, G. J., Spurr, C. D., & Bates, D. W. (2000). Effects of Computerized Physician Order Entry on Prescribing Practices. [1]


Computerized Physician Order Entry (CPOE) has much desired attributes with various potential in improving the quality of healthcare. Its advantage are in preventing prescribing errors, improving healthcare quality, and keeping health costs minimal through user feedback and suggestions to both physicians and pharmacists alike. Prescribing Error can be a significant cause of injury in a healthcare setting. In a study in a healthcare setting 56% of preventable adverse drug events were primarily errors in prescribing.

Prescribing Practices that were used to improve order entry:

  • Educational Learning – Found to be effective but temporary
  • Face – to – Face Review – Found to be expensive

The article explores the impact a CPOE provides for inpatients.[1]


The approach involves an analysis performed using time intervals with Clinical Decision Support (CDS) as a physician enters orders. With the aid of CDS, guidelines on drug use are displayed, alternatives to a drug choice is displayed and advice on appropriate doses and frequencies are suggested. The physician order entry system in combination with the CDS offers recommendations regarding side effects and interventions regarding drug-allergy and drug-drug interactions. The systems also checks for alternate and duplicate medications relative to the patient and the clinical scenario involved.

Study Interventions

  • Medication Selection – a selection of a recommended drug within a class
  • Dosage guidance – a list was generated of suggested does for each of the medication and the recommended dose was highlighted. (Most common dose was recommended if no recommended was not present)
  • Consequent Orders – Gives the physician to accept or decline the prescribing entry
  • Frequency Recommendations – measures the number of orders and administered times.



CPOE influenced prescribing practices by providing dosage guidance and recommended frequency for medication administration through the use of a drug dose selection menu. An 11% decrease in the standard deviation of drug doses being prescribed was also observed. [1]


CPOE improves the quality of prescribing practices and decreases cost by preventing over prescribing of medications. From a patient safety and quality perspective, CPOE offers prescription recommendations, flags drug-drug and drug-allergy interactions and alerts a prescriber on alternate and duplicate medications. [1]


I agree with the authors and the study performed. More credence to the authors as this study was entirely performed in a unique urban, 720 bed academic medical center whose CDS and CPOE system was developed in house by the hospitals IT department.

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  1. 1.0 1.1 1.2 1.3 1.4 Teich, J. M., Merchia, P. R., Schmiz, J. L., Kuperman, G. J., Spurr, C. D., & Bates, D. W. (2000). Effects of computerized physician order entry on prescribing practices. Archives of internal medicine, 160(18), 2741-2747.