Computerized Physician Order Entry (CPOE)

NEED FOR Computerized Physician Order Entry (CPOE) TECHNOLOGY

Medication errors are by far the most common health care errors. Research indicates that among hospitalized patients errors occur in as many as 20% of administered doses of medications. More importantly, 7% of those errors hold the potential of producing potential adverse drug events (ADEs).

Since medication errors are the most common health care errors and many of these errors result in actual harm to patients, correcting this type of error is a priority for improving patient safety. Medication prescribing involves many steps and particular attention is needed to lessen preventable errors that occur during the ordering process. Patient safety is a systems issue, and system changes must be utilized to reduce the incidence of preventable medication errors and ADEs.

Computerized Physician Order Entry (CPOE) is an innovative new technology in medical care that prevents many system failures that are related to human factor limitations and environmental effects on performance.  Medical research has proven the efficacy of this technology in reducing both medication errors and ADEs.  CPOE achieves improvement by decreasing reliance on vigilance and human memory, simplifying and standardizing work processes, and increasing the availability of patient-specific and drug-specific information at the point of service.

CPOE can decrease the frequency of errors related to wrong patient, wrong choice of medication, wrong dosage, wrong frequency, wrong route of administration, and wrong timing. The technology can decrease administration of medications to patients with known allergies and decrease errors in dose calculations.  CPOE incorporates Clinical Decision Support System (CDSS) software that integrates patient-specific information, including gender, age, weight, kidney and liver function, and diagnoses to calculate correct dosages and schedules.  It checks medication regimens for indications, contraindications, and drug-to-drug interactions.

The clinical benefits of CPOE technology extend far beyond reduction in medication errors.  CDSS software can incorporate evidence-based medicine and best practices at the point of physician ordering.  It can integrate electronic order sets and computer logic that allow physicians to order medications, lab tests, and other care modalities that result in improved quality of care, patient safety, and patient outcomes.  These systems can decrease unnecessary variation and standardize best practices for patient evaluation and care.

The Colorado Foundation for Medical Care will be working with hospitals to implement Health Information Technology (HIT) as a key component of the interventions for CPOE, Bar coding, and telehealth technology to improve quality of care, patient safety, and patient outcomes.  We will assist hospitals by engaging senior leadership to adopt interventions and behaviors desirable to focus on improvement.

In August 2005 a letter will be mailed to senior leadership at all Colorado hospitals soliciting support for this effort.  Approximately 15% of acute care hospitals will be selected to participate in this team. The team of hospitals and CFMC will work together to share barrier, best practices, and brainstorm solutions to situations that are common to all entities.  CFMC will also be working individually with hospitals to implement change.

Click the link below to open the assessment document provided in Microsoft Word .doc format.  The assessment can be either printed, completed, and FAX'd, or saved and edited using Microsoft Word, then e-mailed to the CFMC contact below.

CPOE Readiness Assessment Tool

For more information contact Hilarie Olson, Quality Improvement Specialist, at 303.875.6975 or holson@coqio.sdps.org  or Michelle Mills, Project Director, at 303.695.3300 x3038, FAX 303.695.3350, or mmills@coqio.sdps.org.