Main Outcome Measures: Completion data on chemotherapy steps of high morbidity/mortality potential if missed (as determined by attending oncologists) from 1259 pre-CPOE paper and 1116 post-CPOE pediatric chemotherapy orders. Results: After CPOE deployment, daily chemotherapy orders were less likely to have improper dosing (relative risk [RR], 0.26; 95% confidence interval [CI], 0.11-0.61), inco...

ARRA has allocated $20 billion to stimulate the adoption of health IT over the next several years. The largest share of the funding will be for incentive payments through CMS to encourage providers and hospitals to implement health IT systems that demonstrate meaningful use that includes the implementation of CPOE systems. Unfortunately, few tools exist to provide informatics specialists best p...

OBJECTIVE To determine the availability of inpatient computerized physician order entry in U.S. hospitals and the degree to which physicians are using it. DESIGN Combined mail and telephone survey of 964 randomly selected hospitals, contrasting 2002 data and results of a survey conducted in 1997. MEASUREMENTS AVAILABILITY computerized order entry has been installed and is available for u...

Koppel et al s recent report on computerized physician order entry (CPOE) evaluated its role in facilitating medication errors [1]. Such studies are important because they can inform us regarding how to improve technologies like CPOE. This evaluation is also valuable because the authors studied a vendor-built product, and vendor-developed applications are the predominant type used in the U.S. t...

OBJECTIVES Children treated with chronic medications are at risk of drug-drug interactions (DDIs) when hospitalized with an acute illness and prescribed new medications. We aimed to measure the prevalence of potential DDIs (pDDIs) among hospitalized children treated with antiepileptic drugs (AEDs) and to evaluate the impact of computerized physician order entry (CPOE) on pDDIs. METHODS We ana...

BACKGROUND With the introduction of Computerised Physician Order Entry (CPOE) in routine hospital care, a great deal of effort has been put into refining Clinical Decision Support Systems (CDSS) to identify patients at risk of preventable medication-related harm. OBJECTIVES This study compared a CPOE with basic CDSS and 16 clinical rules with a manual pharmacist medication review to detect ov...

BACKGROUND There are numerous barriers to successfully implementing computerized provider order entry (CPOE), and it is not entirely clear to what degree the proposed benefits extend to older, commercially available systems in place at most hospitals. METHODS In 2000, Loyola University Health System leadership chartered a project to implement CPOE for hospitalized patients' medications. The i...

Interest in studying distractions and interruptions in the context of clinician workflow has increased in light of evidence that these events may negatively impact patient safety. Additionally, many recent informatics-based studies analyze computer provider order entry (CPOE) and clinical information system (CIS) implementation and its effects on clinician workflow. This study expands the devel...

Objective: To identify and summarize the requirements of an optimized CPOE application for pediatric intensive care. Methods: We analyzed the medication process and its documentation in the pediatric and neonatal intensive care units (PICU/NICU) of two university hospitals using workflow analysis techniques, with the aim of implementing computer-supported physician order entry (CPOE). Results: ...

This study investigates how CPOE system users choose data input strategies for entering clinical orders. Complex systems often allow more than one way to complete a task. However, the appropriate entry strategy in the context of a specific clinical workflow situation may not be apparent to users. We have conducted a cognitive analysis of user interaction strategies for entering IV injection ord...