Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems

By D. Radley, Melanie R. Wasserman, Lauren E. W. Olsho, Sarah J. Shoemaker, M. Spranca, B. Bradshaw. J. Am. Medical Informatics Assoc., 2013

333 citations recorded by the source corpus.

Objective Medication errors in hospitals are common, expensive, and sometimes harmful to patients. This study's objective was to derive a nationally representative estimate of medication error reduction in hospitals attributable to electronic prescribing through computerized provider order entry (CPOE) systems. Materials and methods We conducted a systematic literature review and applied random-effects meta-analytic techniques to derive a summary estimate of the effect of CPOE on medication errors. This pooled estimate was combined with data from the 2006 American Society of Health-System Pharmacists Annual Survey, the 2007 American Hospital Association Annual Survey, and the latter's 2008 Electronic Health Record Adoption Database supplement to estimate the percentage and absolute reduction in medication errors attributable to CPOE. Results Processing a prescription drug order through a CPOE system decreases the likelihood of error on that order by 48% (95% CI 41% to 55%). Given this effect size, and the degree of CPOE adoption and use in hospitals in 2008, we estimate a 12.5% reduction in medication errors, or ∼17.4 million medication errors averted in the USA in 1 year. Discussion Our findings suggest that CPOE can substantially reduce the frequency of medication errors in inpatient acute-care settings; however, it is unclear whether this translates into reduced harm for patients. Conclusions Despite CPOE systems’ effectiveness at preventing medication errors, adoption and use in US hospitals remain modest. Current policies to increase CPOE adoption and use will likely prevent millions of additional medication errors each year. Further research is needed to better characterize links to patient harm.

Subfields: Emergency Medical Services, Geriatrics and Gerontology, Health Information Management

View Paper: https://www.semanticscholar.org/paper/4c3cd02a005fea7ce75abf83210e5a4928334dd5

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Citations in the corpus

• The impact of computerised physician order entry and clinical decision support on pharmacist-physician communication in the hospital setting: A qualitative study (2018, background): “The implementation of Computerised Physician Order Entry (CPOE) has been shown to have many benefits for patients and healthcare professionals, in particular a reduction in medication errors and preventable adverse drug events [1, 2].”
• The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis (2014, background): “We used this strategy to search the eight databases for systematic reviews of CPOE or CDSS that might contain potentially relevant primary studies (last updated September 23, 2013) (Figure 1).”
• Health Information Technology: An Updated Systematic Review With a Focus on Meaningful Use (2014, background): “The same is true for CPOE: Most evaluations have reported positive or mixed-positive effects, and most existing systematic reviews likewise conclude that CPOE reduces medication errors (34, 35).”