Blog | Tuesday, February 26, 2013

QD: News Every Day--Computerized order entry reduces errors, but may not affect patient harm


Computerized provider order entry (CPOE) systems can prevent 17.4 million medication errors in inpatient acute-care settings in the U.S. annually, a study found, although it couldn't determine how this might reduce harm to patients.

Researchers conducted a systematic literature review and meta-analysis to examine how CPOEs affected medication error rates. Results appeared online Feb. 21 at the Journal of the American Medical Informatics Association.

More than one-third of U.S. acute-care hospitals had adopted CPOE by 2008. Among the more than 2,800 hospitals that responded to a survey, larger hospitals (more than 400 beds) were more likely to have adopted CPOE (56%) compared with medium-sized (35%) or small hospitals (30%); urban hospitals were more likely than rural ones (41% vs 28%; P less than 0.001); major teaching hospitals were more likely than non-teaching hospitals (53% vs 32%; P less than 0.001); and not-for-profit hospitals (37%) were more likely to do so than public hospitals (31%) and private for-profit hospitals (32%).

After pooling data from nine studies about the impact of CPOE, researchers estimated that medication error rates were 48% lower after implementing a CPOE (95% confidence interval [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 annually," the researchers wrote. However, it is unclear whether reduced medication errors would translate into reduced patient harm from medications. Several studies looked at reduced patient harm, but are not enough to form a meta-analysis, the researchers added.