For a successful design and deployment of computerized provider order entry (CPOE) systems which support medical workflow, thorough understanding of workflow and its changes after the CPOE implementation are crucial. For this purpose, this PhD study incorporates insights from multiple disciplines and uses mixed research methods to study a CPOE implementation case at a Dutch hospital. The study ...

Clinical distractions may account for 43% of medication errors. "Silent errors" in Computer Provider Order Entry (CPOE) warrant a new perspective for interruption analysis. We developed a taxonomy of interruptions in the context of CPOE. In two hours of observed CPOE use by residents during Medical Intensive Care Unit (MICU) rounds, one distraction or interruption occurred approximately every 5...

OBJECTIVES Computerized provider order entry (CPOE) has been established as a method to improve patient safety by avoiding medication errors; however, its effect on emergency department (ED) flow remains undefined. We examined the impact of CPOE implementation on three measures of ED throughput: wait time (WT), length of stay (LOS), and the proportion of patients that left without being seen (L...

BACKGROUND Founded in 2000, the Leapfrog Group includes more than 65 employers and agencies that together purchase care for more than 34 million people. It has focused on measuring and reporting hospitals' adoption of evidence-based practices to improve patient safety. Whether this program helps identify high-quality hospitals is unknown. A study was conducted to determine whether hospitals tha...

BACKGROUND Oncology has lagged in CPOE adoption due to the narrow therapeutic index of chemotherapy drugs, individualized dosing based on weight and height, regimen complexity, and workflows that include hard stops where safety checks are performed and documented. OBJECTIVES We sought to establish CPOE for chemotherapy ordering and administration in an academic teaching institution using a co...

OBJECTIVE Computerized provider order entry (CPOE) has been shown to improve patient safety by reducing medication errors and subsequent adverse drug events (ADEs). Studies demonstrating these benefits have been conducted primarily in the inpatient setting, with fewer in the ambulatory setting. The objective was to evaluate the effect of a basic, ambulatory CPOE system on medication errors and ...

To cite: Payne TH. BMJ Qual Saf 2015;24:239–240. For decades we have looked hopefully to electronic health records (EHRs) to aid efforts to make healthcare safer. Early research gave basis to this hope: automated alerts and reminders were shown to improve preventive and chronic illness care, electronic records could be better organised and more easily delivered where needed, automated computeri...

Background: Clinical decision support (CDS) functionalities in Computerized Provider Order Entry system (CPOE) need to be identified by the institutional healthcare providers developing countries. In this regard, CDS should a priority for execution CPOE. Objectives: Thus, our study was done identify and prioritize Methods: A Two-round Modified Delphi process used. Firstly, systematic search con...

OBJECTIVE To understand the medium-term consequences of implementing commercially procured computerized physician order entry (CPOE) and clinical decision support (CDS) systems in 'early adopter' hospitals. MATERIALS AND METHODS In-depth, qualitative case study in two hospitals using a CPOE or a CDS system for at least 2 years. Both hospitals had implemented commercially available systems. Ho...

INTRODUCTION Prescribing medication is an important aspect of almost all in-hospital treatment regimes. Besides their obviously beneficial effects, medicines can also cause adverse drug events (ADE), which increase morbidity, mortality and health care costs. Partially, these ADEs arise from medication errors, e.g. at the prescribing stage. ADEs caused by medication errors are preventable ADEs. ...