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Computer order entry systems reduce drug events


Computer order entry systems (CPOE) are effective at reducing drug-related injury and harm, according to research published in the Journal of General Internal Medicine.

Brigham and Women’s Hospital in America examined the impact of a vendor-developed CPOE in five community hospitals in Massachusetts.

“We knew from prior research that there was potential to significantly reduce preventable adverse drug events (ADEs) at community hospitals through CPOE,” said lead author Dr David Bates, Senior Vice President for Quality and Safety at Brigham and Women’s Hospital.

“Our research demonstrates that this is true. We observed a 34% reduction in preventable ADEs overall in the community hospital setting following the implementation of a vendor CPOE system.”

Researchers evaluated the impact of CPOE systems on the frequency of ADEs in five community hospitals in Massachusetts between January 2005 and September 2011.

Each hospital independently selected and implemented a vendor CPOE system with decision support capabilities.

They looked at the incidence of preventable ADEs and the rate of potential ADEs and ADEs overall.

An ADE was defined as any drug-related injury. They were considered preventable if they were due to an error or were preventable by any means available.

A non-preventable ADE was defined as any drug-related injury in which there was no error in the medication process.

A potential ADE, or near miss, was defined as a medication error with the potential to cause harm to the patient, but did not actually cause injury.

Researchers observed a 34% reduction for preventable ADEs, but an increase of 29.5% in potential ADEs or near-misses following implementation of a CPOE system.

“Our study shows that while rates of preventable ADEs may fall after CPOE implementation, all sites can benefit from tracking issues found post-implementation and making changes accordingly,” said Bates.

“The expertise and experience of others that have previously implemented CPOE can help guide the process.”

Bates and colleagues suggested that further research is needed to explore the safest and most effective way to implement vendor CPOE and other technology.

Bates and colleagues are currently investigating the impact of clinical decision support systems on ADE rates and identifying barriers to implementation.


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