BACKGROUND The Health Information Technology for Economic and Clinical Health (HITECH) Act subsidizes implementation by hospitals of electronic health records with computerized provider order entry (CPOE), which may reduce patient injuries caused by medication errors (preventable adverse drug events, pADEs). Effects on pADEs have not been rigorously quantified, and effects on medication errors ...

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...

OBJECTIVE To reduce the probability of failure in the oral chemotherapy order, review and administration process and to reduce oral chemotherapy-related prescribing errors intercepted by clinical pharmacists prior to reaching the patient. DESIGN A before-and-after cohort study. SETTING A 719-bed multidisciplinary tertiary care institution with a pediatric division and an outpatient cancer c...

OBJECTIVES To determine what information can be helpful in prioritizing and presenting medication alerts according to the context of the clinical situation. To assess the usefulness of different ways of delivering medication alerts to the user. DESIGN An international Delphi study with two quantitative rounds. 69 researchers with expertise in computerized physician order entry (CPOE) systems ...

The adoption of EMR systems has been argued to lead to physicians “upcoding” their patients to inflate insurance reimbursements. In this paper, we examine if the adoption of the Clinical Physician Order Entry (CPOE) system is associated with an increase in the complexity of the patients' case mix that hospitals report (termed "upcoding"). We make use of a staggered roll-out of the Recovery Audi...

SINCE PUBLICATION OF TO ERR IS HUMAN, ELECTRONIC health records (EHRs) and related health information technologies have been promoted as means to improve patient safety. This promise remains largely unfulfilled. For instance, whereas EHRs with clinical decision support (CDS) interventions integrated into computerized physician order entry (CPOE) have measurably improved clinicians’ performance ...

Medication errors and adverse drug events (ADEs) are serious hazards for patients all over the world. Reports of the Institute of Medicine (IOM) estimate that a patient in an US-hospital faces at least one medication error per day [1, 2]. Most medication errors, and a majority of ADEs, occur during the prescription phase of the medication cycle [3 –5]. Amongst other approaches, the Institute of...

The importance of health informatics evaluations adopting a pluralist approach which considers the technical as well as the organizational and social aspects of system implementation has been espoused by many researchers. Kaplan's 4Cs evaluation framework presents a lens through which evaluations of clinical systems can be assessed, with a focus on communication, care, control and context. Our ...

Objective: This paper aims to outline a suite of key indicators of Computerised Pathology Order Entry (CPOE) performance, assess their value as measurements of care delivery and their relevance to health professionals and patients. Background: CPOE systems have the potential to deliver substantial effi ciency gains along with improvements in the effectiveness and quality of patient care. Howeve...

Design: The CIM arose from qualitative data collected from four clinical units in two large Australian teaching hospitals. The aim of the study was to explore physicians’ test management work practices associated with the compulsory use of a hospital-wide, mandatory computerized provider order entry (CPOE) system. The dataset consisted of non-participatory observations of physicians using CPOE ...