Potential benefits and problems with computerized prescriber order entry: Analysis of a voluntary medication error-reporting database
Abstract
PURPOSE: The potential benefits and problems associated with computerized prescriber-order-entry (CPOE) systems were studied. METHODS: A national voluntary medication error-reporting database, Medmarx, was used to compare facilities that had CPOE with those that did not have CPOE. The characteristics of medication errors reportedly caused by CPOE were explored, and the text descriptions of these errors were qualitatively analyzed. RESULTS: Facilities with CPOE reported fewer inpatient medication errors and more outpatient medication errors than facilities without CPOE, but the statistical significance of these differences could not be determined. Facilities with CPOE less frequently reported medication errors that reached patients (p < 0.01) or harmed patients (p < 0.01). More than 7000 CPOE-related medication errors were reported over seven months in 2003, and about 0.1% of them resulted in harm or adverse events. The most common CPOE errors were dosing errors (i.e., wrong dose, wrong dosage form, or extra dose). Both quantitative and qualitative analyses indicate that CPOE could lead to medication errors not only because of faulty computer interface, mis-communication with other systems, and lack of adequate decision support but also because of common human errors such as knowledge deficit, distractions, inexperience, and typing errors. CONCLUSION: A national, voluntary medication error-reporting database cannot be used to determine the effectiveness of a CPOE system in reducing medication errors because of the variability in the number of reports from different institutions. However, it may provide valuable information on the specific types of errors related to CPOE systems.
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In contrast to the MEDMARX data, a larger proportion of incidents related to computer system failures was found (2.8% MEDMARX vs 9.4%).
“In contrast to the MEDMARX data, we found a larger proportion of incidents related to computer system failures (2.8% MEDMARX vs 9.4%).17”
From An analysis of computer-related patient safety incidents to inform the development of a classification (2010) · cites this paper as [17]
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- Authors
- Zhan, C., Hicks, R. W., Blanchette, C. M., Keyes, M. A., & Cousins, D. D.
- Affiliations
- Agency for Healthcare Research and Quality (US)
- United States Pharmacopeial Convention (US)
- University of Maryland, Baltimore (US)
- Universidad San Pedro (PE)
- Corresponding author
- Zhan, Chunliu
- Venue
- American Journal of Health-System Pharmacy
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-02-15
- Volume
- 63
- Issue
- 4
- Pages
- 353-358
- ISSN
- 1079-2082 (ISSN-L)
- 1535-2900
- OpenAlex
- W2095509663
- Cited by
- 126
- References
- 16
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 5 · 2018: 1 · 2017: 11 · 2016: 10 · 2015: 5 · 2014: 5 · 2013: 11 · 2012: 11
- FWCI
- 16.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Health-System Pharmacy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- computerized physician order entry, medication errors, medication error reporting, dosing errors, clinical decision support, human error, patient harm
- MeSH terms
- Computers, Humans, Medication Errors, Medication Systems, Drug Prescriptions, Databases as Topic, Medical Order Entry Systems
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