Difference between revisions of "Can Utilizing a Computerized Provider Order Entry (CPOE) System Prevent Hospital Medical Errors and Adverse Drug Events?"
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Revision as of 01:07, 6 November 2015
This is a review on an article that examined the benefits and barriers of Computerized Provider Order Entry (CPOE) adoption in inpatient hospitals to determine the effects on medical errors and Adverse Drug Events (ADEs). The study also examined the cost and savings associated with the implementation of this new technology. [1]
Contents
First Review
Introduction
Providers and hospitals are continuing to moving forward towards using electronic medical records to meet the meaningful use standards and receive the financial incentives. In each of the meaningful use stages computerized provider order entry is one of the required measures for providers and hospitals. The majority of medical mistakes occur with orders services due to illegible handwriting and ADEs. A CPOE system can decrease the number of ADEs in a hospital, enhance patient safety, and decrease preventable medical errors. [1]
Methods
The method the authors used for their research in examining the benefits of and barriers to CPOE adoption was conducted in 3 stages:[1]
- identifying the literature and collecting the data
- analyzing and evaluating the literature found
- categorizing the literature
Results
The results of this research study found that there were multiple benefits towards adopting and implementing a CPOE system. Some of the benefits found include: [1]
- increased accessibility to patient records
- ability for physicians to access records from home or office
- 70% reduction in medication errors compared to paper records
- increased care coordination
Discussion
Many hospitals and providers are implementing CPOE systems within their electronic systems. Research is showing the reduction in medical errors and adverse drug effects. This will promote patient safety, better patient outcomes and care and also save hospitals and providers millions of dollars from preventable medical errors.[1]
Limitations
The literature research was limited to the number of databases that were accessed.Publication and researcher bias may have affected the selection of sources. Also because CPOE is still fairly new few facilites that have fully adopted the system are available to be examined.[1]
Conclusion
CPOE is an effective sollution toward reducing and limiting medication errors and adverse drug events. CPOE can also be a cost savings for many facilities from potential patient safety events. CPOE allows physicians to have additional knowledge at their fingertips and patient related information that is intelligently filtered and presented at appropriate times. Evaluation and better estimates of the financial impact of CPOE CPOE are still needed to assess its financial feasibility. [1]
Related Article
Return on investment for vendor computerized physician order entry in four community hospitals: the importance of decision support[2]
Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients. [3]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Can Utilizing a Computerized Provider Order Entry (CPOE)System Prevent Hospital Medical Errors and Adverse Drug Events"?.http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pmc/articles/PMC4272436/
- ↑ Zimlichman et al. Return on investment for vendor computerized physician order entry in four community hospitals: the importance of decision support. Jt Comm J Qual Patient Saf. 2013; 39(7):312-8. http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pubmed/23888641
- ↑ Vermeulen, KM, JE van Doormaal, RJ Zaal et al. Cost-effectiveness of an electronic medicationordering system (CPOE/CDSS) in hospitalized patients. Int J Med Inform. 2014:83: 572-580.
Second Review
Background
According to Institute of Medicine report published in 1999, medication errors are responsible for at least 44000 to 98000 deaths each year in USA. Approximately 50% these medication errors are related to adverse drug events (ADE) which are preventable. Implementation of CPOE in hospital system can reduced adverse drug events and also decreases in medication errors such as incorrect dosages, incomplete orders, duplicate therapies, drug allergies etc. However implementing CPOE system will unable to produce desired results as there are many constrains and other factors are associated with its success. The purpose of this research study was to examine the benefits of and barriers to CPOE adoption in hospitals to determine the effects on medical errors and adverse drug events (ADEs) and examine cost and savings associated with the implementation of this newly mandated technology
Material and Methods
This study was conducted in three stages. 1. identifying the literature and collecting the data 2. 2.analyzing and evaluating the literature found 3. Catogoring the literature. The literature review and review of case studies was performed in January to May 2013 and September 2013 to March 2014. The Academic Search Premier, PubMed, ProQuest, ScienceDirect, and Google Scholar electronic databases were searched for the terms “CPOE” OR “Computerized Physician Order Entry” OR “Electronic Prescribing” AND “Medical Errors” OR “ADEs” OR “Adoption” OR “Implementation” AND “Meaningful Use” OR “HITECH.” Reputable websites from the Agency for Healthcare Research and Quality, Health Affairs, and CMS were also used.The literature review framework was developed for inclusion and exclusion of the articles.
Results
The literature review of this study shows benefits and barriers related to CPOE implementation.The main barriers are higher cost of CPOE implementation,physician hesistation,lack of system interoperatibility and user errors.The benefits of CPOE implementation are accessibility of the patients medical records, the ability for a physician to work off-site from home or another office and still have access to information about a patient's past visits,70 percent reduction in medication errors.The study results also indicates thatCPOE systems in hospitals are capable of reducing medical errors and ADEs, especially when CPOE systems are bundled with clinical decision supportCDS systems designed to alert physicians and other healthcare providers of pending lab or medical errors.
Discussion
The main limitation of the study was its sample size.Its small sample size threatens its external validity. The more research will need in this area with broaden scope of acceptance criteria and it also have to address its method to increase external validity. The second limitation of the study is the limiting the amount of useful searchable publications as CPOE is fairly new and fewer facilities that have fully adopted the system are available to be examined.
Comments
CPOE systems have the potential to be an effective solution for limiting hospital medical errors and ADEs experienced in the United States. CPOE adoption can facilitate the reduction of medical errors and ADEs as well as creating cost savings in hospitals
