The Downside of E-Prescribing
The study, conducted by the University of Pennsylvania and published in the Journal of the American Medical Association, discovered 22 situations in which a CPOE system could cause or contribute to errors. Interfaces were one of the biggest sticking points, as doctors sometimes have to wade through multiple screens to get information on a single patient. Systems could also generate multiple patient names, confusing the doctors and possibly leading to an erroneous prescription.
The study, however, focused on an older CPOE system that has since been replaced. A followup study conducted at Harvard found that CPOEs could reduce errors by up to 80%.
The lesson of the studies is not that CPOE doesn't work, but that -- as with any system -- care needs to be taken in designing user-friendly interfaces, optimizing workflow and processes, and training doctors. These issues are explained in greater detail in a report from the Institute for Safe Medication Practices. These issues will become more prominent as more US hospitals implement COE systems to increase patient safety, and in response to the Bush administration's push toward universal electronic medical records.
UPDATE: On the topic of patient safety and prescriptions, two babies at Boston's Bringham and Women's Hospital were accidentally given 10 times the prescribed dose of Tylenol this past weekend. A nurse gave the newborn boys 4cc of the medication instead of the recommended 0.4cc. Fortunately, the babies are all right, and are not expected to suffer any harm as a result. No word on whether a CPOE system was involved.