A computerized order entry system that actually works

Despite a recent study in the Journal of the American Medical Association (3/9/05) suggesting that computerized physician order entry (CPOE) systems may not live up to their promise of reducing medication errors, the Illinois Hospital Association has decided to launch a pilot CPOE program in 26 hospitals in the state. The pilot program hopes to capitalize on the success of a computerized system implemented at St. Francis Hospital in Peoria, Ill., which reduced adverse drug reactions "from 4 per 1,000 doses of medication 5 years ago to 1.4 today," according to the Chicago Tribune (4/11/05).

The researchers of the JAMA study looked at a CPOE system used in an urban teaching hospital and found that the system contributed to the occurrence of 22 types of medication errors. (For more about the JAMA study, see the May issue of Contemporary Ob/Gyn) Proponents of automated health-care systems that help improve drug safety downplay the study's findings, noting that the researchers studied an older CPOE system. The study also did not examine whether the CPOE system actually reduced the volume of errors-by comparing the error rate before and after the system was introduced-according to David Bates, medical director of clinical quality and analysis in information systems at Partners HealthCare Systems in Boston (Modern Healthcare, 3/14/05).