Physician order entry system reduces error

The incidence of medication errors can be reduced by implementing a computerized physician order entry (CPOE) system, according to a review of several studies conducted by researchers at the University of Minnesota.

The review, recently published in the online journal Health Services Research, analyzed 12 studies conducted between 1990 and 2005 that compared the number of handwritten and computerized medication errors made by hospital physicians. Medication errors, which include prescribing the wrong drug, ordering an inaccurate dosage, or administering a drug at the wrong time, dropped by as much as 66 percent in United States hospitals that switched to a CPOE system. Illegible handwriting and transcription errors account for more than 60 percent of medication errors.

Patient safety is our final goal, said Tatyana Shamliyan, lead review author and a research associate at the University of Minnesota School of Public Health.Evidence from these studies show that computerized systems can reduce mistakes, but unfortunately less than 50 percent of hospitals have implemented these systems. There is a lot of work to be done in the future.

The rate of medication errors experienced by hospitals has skyrocketed from only 5 percent in 1992 to nearly 25 percent today. The review found that of these hospitals, CPOE systems were most beneficial when the rate of medication errors was more than 12 percent.

The Institute of Medicine has already identified medication errors as a major threat to patient safety and has endorsed electronic prescribing of medication as an effective method in correcting the problem.Medication errors are a central aspect of improving hospital safety. CPOE can help that process, says Robert Kane, M.D., review co-author.

Hospitals would be short-sighted not to use it. Kane also notes that CPOE systems can be combined with existing computerized medical records, creating a central location for physicians to efficiently enter and view past and present patient prescriptions and medical history.

While the review found that the number of medication errors dropped as a whole, the incidence of one type of error, prescribing the wrong drug, did not decrease. In five of the twelve studies, the number of adverse events from drugs errors did not decrease. More than one-half million patients suffer injuries or death from adverse events, causing up to $5.6 million annually per hospital, according to the review.