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Computer Physician Order Entry Benefits Costs And Issues Pdf

computer physician order entry benefits costs and issues pdf

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In addition, given the absence of a robust ROI literature base, we review the general benefits and potential costs of various health IT applications including electronic health records EHRs , computerized physicians order entry CPOE systems, and clinical decision support systems CDSS.

CiteScore measures average citations received per document published. Read more. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact. SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

Computerized Physician Order Entry : Costs , Benefits and Challenges

CiteScore measures average citations received per document published. Read more. SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Information is scarce on the impact of the clinical electronic record on the frequency and severity of medication errors in acute geriatric patients..

An analytical and descriptive pre—post study was conducted on the implementation of computerized provider order entry systems CPOE , over a 6 year period. A total of medication errors patients were detected in the period of study, and represented the first adverse event reported By drugs dispensed, adverse events were 2.

For serious errors and by doses dispensed, there were 5. Frequent medication errors were found in acute geriatric patients. An increase in medication errors and a decline in the severity of the detected errors were found in relationship to the electronic clinical record.

For these reasons, the implementation of the electronic clinical record should be monitored.. Se detectaron un total de 1. The medication use process poses a significant safety risk for hospitalized patients in each of its phases prescription, dispensation, administration or monitorization.

There are several published studies showing that many adverse drug events ADEs are preventable 1—6 and prescribing errors occur in 0. Elder patients may be more vulnerable to medication errors because of the larger number of medications administered on a daily basis, 10 and the number of opportunities for error is substantial in places such as nursing homes where the incidences rates range from 1.

Computerized provider order entry systems CPOE have been consistently identified as an important intervention with the potential to reduce prescribing errors and injury. Although voluntary reporting systems have serious limitations, such systems provide data that can be used to target patient safety improvement.

Because there are scarce data and that the majority of the studies have serious limitations, this study describes the epidemiology and severity of medication errors detected in an acute geriatric hospital, and the impact of the electronic clinical record on reducing these errors.

Monte Naranco Hospital Oviedo, Spain is a bed bed occupation rate was Analytical and descriptive study pre—post CPOE implementation.

A six year period using a voluntary reporting system, the former period — with a hand-writing system and the latter period — with the clinical electronic record CER Selene, Siemens, Germany. The computerized physician order entry has three main screens: a prescription screen by commercial, substance or drug groups , b drug substance in the Pharmacy hospital repository and the rest of the drugs, and c standard procedures route, doses, frequency and duration of treatment and a free narrative text.

The reporting systems and the methodology were the same in the six-year period of study and there were no changes in the period except to the introduction of the CER in the year In the period of the study the following interventions were implemented: a — incorporation of reporting systems and analysis of causes and contributory factors, staff training about medication errors; b CER, Pharmacological Guide in CER and following group of the CER; c — incorporation of different patches in the CER, evaluation and analysis of the medication errors, periodically feedback was provided to the physicians.

Medication error was defined as an error which can occur at any of the phases of the medication use process; in this definition side effects of the medication are not included. The following data were collected: a patient characteristics age, sex, Barthel index and pathologies i. The data were anonymised and aggregated. The contributory factors were categorized by Charles Vincent's Scheme 21 and by Ruiz-Jarabo's classification.

A p value of The medication errors were the first adverse events reported These figures represent 0. By severity, there were 0. By medication group using the GMEI : the mot frequent errors were produced in the following groups: antihistamines Errors and group of medications In the period —, there were errors per discharges 5. By dispensation drugs, there were 4.

By medication groups, there were more frequent errors in: antibiotics 1. There was no statistical significance in other variables. RR of number of errors with statistical significance. In the period of —, there were 33 moderate—serious errors E—I from the errors 9. By discharges, 4. By type of error: drug omission RR of number of serious errors with statistical significance. In the literature review, 9 just 12 valid studies were identified between and from articles about prescription errors in hospital inpatients: 7 pre and post-implementation CPOE studies two with voluntary reporting system , 2 time series, 1 cross-sectional, 1 crossover and 1 comparative cohort in the United States, the UK, Europe and Israel.

In four studies patients were paediatric patients and in the rest of the nine studies were adults 3 in Intensive Care Unit — ICU — and 5 in adult general hospitals — two studies relied upon voluntary reporting. Our study was in acute geriatric patients and in Spain, where there are no data about this topic in our knowledge. Spencer et al. Mahoney et al. In general, there is a significant reduction in prescribing errors rates for all or some drug types in the 12 studies. In just five studies estimated the prescribing error severity 9 and the evidence is limited by modest sample sizes and designs such as the classes of severity.

According to Reckmann?? On the contrary, our limitation is the use of a voluntary reporting system, with under-reporting of errors. Although we think that our results can be significant in the same way of other valid studies, other studies show that these voluntary reporting systems identify just a 1. In a previous study, 26 we showed the increase of the notification and record of adverse events, the increase of the reporting systems from 4 to 10 and the prevalence of medication errors of For these reasons, this could be the cause of the bias in the increased number of medication events, although the three methods used in this paper IR2 report form from the NHS — UK National Health Service, the Global Trigger Tool — GTT — and the walk rounds with the Pharmacy Service were the same methods used in the period of the study.

The nature of the sources in the reporting systems does not let us know the ranking and real figures of the adverse events, and it is necessary to establish priorities and to stagger the different reporting systems and according to cost effectiveness measures. The reporting systems are the first step to analysis and it might be necessary to improve and to mitigate the adverse events.

This bias could be solved with the use of other data sources. In our study, voluntary reporting systems were used, at the same time the GTT and walk rounds have also been used. Other limitation could be that the CER is described in reference centers with different culture than the existing one in small or medium hospitals such as our hospital. The main goal in this study is that CPOE must be monitored during and after its implementation in order to detect the occurrence of new medication errors.

In conclusion, the study conducted in acute geriatric patients detected an increase in the reported errors and the decline of the severity of the errors related to the CER. Accordingly, we recommend that the follow-up of the implementation of the CER in hospitals should be monitorized to determine the impact of the medication errors. The authors have no conflicts of interest to declare. Inicio Revista de Calidad Asistencial Impact of computerized physician order entry on medication errors.

ISSN: X. Previous article Next article. Issue 6. Pages November - December Impact of computerized physician order entry on medication errors. Download PDF. Menendez a , J. Alonso b , I. Corte c , V. Herranz d , F. Vazquez a , e ,?? Corresponding author. This item has received.

Article information. Table 1. Table 2. Show more Show less. Background Information is scarce on the impact of the clinical electronic record on the frequency and severity of medication errors in acute geriatric patients.

Material and methods An analytical and descriptive pre—post study was conducted on the implementation of computerized provider order entry systems CPOE , over a 6 year period. Results A total of medication errors patients were detected in the period of study, and represented the first adverse event reported Conclusion Frequent medication errors were found in acute geriatric patients.

For these reasons, the implementation of the electronic clinical record should be monitored. Medication errors. Resultados Se detectaron un total de 1. Palabras clave:. Introduction The medication use process poses a significant safety risk for hospitalized patients in each of its phases prescription, dispensation, administration or monitorization. Table 3. Table 4.

Table 5. Bates, L. Leape, S. Incidence and preventability of adverse drug events in hospitalized adults. J Gen Intern Med, 8 , pp.

Physician characteristics, attitudes, and use of computerized order entry

David C. Avery, DM, David W. Computerized physician order entry CPOE is an application that is used to electronically write physician orders either in the hospital or in the outpatient setting. Hospitals and a smaller percentage of ambulatory clinics. It is linked with clinical decision support, which provides much of the value of implementing it. A number of studies have assessed the impact of CPOE with respect to a variety of parameters, including costs of care, medication safety, use of guidelines or protocols, and other measures of the effectiveness or quality of care.

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. Computerized Physician Order Entry has emerged as the greatest potential to decrease medications errors and improve efficiency. A literature review was conducted in systematic stages that included the research data from the last 25 years. Efficiencies were found with a decrease in overall workload of nurses, pharmacists and clerical workers. This led to decreased operating expenses. Save to Library.

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. Research indicates that computerized physician order entry CPOE has the potential to reduce medication errors and adverse drug events and thus improve the quality of care. However, successfully implementing CPOE is difficult and expensive. An estimated five percent of hospitals now have CPOE, but many more are considering this investment. Save to Library.

computer physician order entry benefits costs and issues pdf

Computer physician order entry and clinical decision support systems: Benefits and concerns

Computerized provider order entry CPOE systems allow physicians to prescribe patient services electronically. In hospitals, CPOE essentially eliminates the need for handwritten paper orders and achieves cost savings through increased efficiency. 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.

We calculated the order entry rates of attending physicians at 2 hospitals by measuring the number of orders entered directly and dividing this by the sum of orders entered directly and those written by hand. These findings were paired with the results of a survey that assessed attitudes concerning the impact of CPOE on personal efficiency, quality of care, and patient safety. Sex, years since medical school graduation, years in practice at the study institution, and use of computers in the outpatient arena were not meaningfully different among the 3 groups.

Role of Computerized Physician Order Entry Systems in Facilitating Medication Errors

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2 Comments

  1. Steve F.

    06.05.2021 at 00:30
    Reply

    Few researchers, however, have focused on the existence or types of medication errors facilitated by CPOE.

  2. Tarpharema

    08.05.2021 at 04:32
    Reply

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