CPOE: It Don’t Come Easy

HDM Breaking News, January 7, 2009

Focusing on the need to dramatically reduce medical errors, many patient safety advocates have urged hospitals to implement computerized physician order entry systems. But so far, only about 8% of U.S. hospitals have implemented CPOE, the Leapfrog Group estimates.

And a recent study by the Washington-based employer consortium found that hospitals that have adopted the technology are facing some serious challenges.

Some 100 hospitals recently used Leapfrog’s CPOE Evaluation Tool, which offers scenarios for testing certain order entry functions. And the results were disappointing, says Leah Binder, Leapfrog’s CEO.
For example, although the vast majority of drug allergies were caught by the systems, some were not.

Also, some hospitals’ CPOE systems failed to offer an alert that a drug should be taken with food. And a few hospitals’ systems even failed to prevent a potentially fatal medication order in the simulation.
“It’s extremely complicated to set up these systems properly,” Binder says. “They have to be updated continually. There are always going to be bugs that you need to address on an ongoing basis.”

Hospitals face the challenge of customizing the off-the-shelf software to meet their specific needs, Binder adds. “These are not plug-and-play systems,” she stresses.

Many experts also warn that hospitals must take extraordinary steps to avoid “alert fatigue” caused by vendors’ systems that are pre-programmed to display so many alerts that physicians begin to ignore most of them. Moreover, successful deployment of CPOE requires time-consuming re-engineering of care processes, they stress.

To read an in-depth CPOE cover story from the January issue of Health Data Management, click here.

--Howard Anderson

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