It’s a growth industry

Computerized order entry reduces medication errors

NEW YORK (Reuters Health) – Implementation of a computerized physician order entry system in hospitals significantly reduces medication prescribing errors, according to results of a review of 12 published studies that compared rates of prescribing medication errors with handwritten and computerized order entry systems for in-hospital physicians.

Compared with handwritten orders, 80% of studies (8 of 10) found significant reductions in total prescribing errors with computerized order entry systems, 43% (3 of 7) showed reductions in dosing errors, and 37.5% (3 of 8 studies) reported significantly fewer adverse drug events.

The use of computerized compared to handwritten physician orders was associated with a “66% reduction in total prescribing errors in adults,” lead author of the review Dr. Tatyana Shamliyan told Reuters Health.

The benefits of a computerized physician order system were greatest in hospitals with high baseline error rates (more than 12%) with handwritten orders, she also noted.

Dr. Shamliyan of the University of Minnesota School of Public Health, Minneapolis, Dr. Robert L. Kane, also of UM, who conceptualized the review, and two colleagues report their results in the journal Health Services Research.

“Medication errors are a central aspect of improving patient safety,” Dr. Shamliyan concluded. “More well designed research is needed to analyze the effects of different computerized physician order systems on clinical events related to errors. Doctors and pharmacists should agree on clear definitions of medication errors including off-label dosing and combinations of the drugs.”

The majority of the studies reviewed were conducted in teaching hospitals. The effects of computerized physician order entry systems in “more typical practice settings where the level of care may be different remains to be determined,” she added.

Currently, only about 9% of U.S. hospitals have computerized prescription systems. However, more and more health systems are moving in this direction. “It’s a growth industry,” Dr. Kane said in a written statement.

Health Serv Res 2007.