Computerized physician order-entry systems can facilitate as well as prevent medication errors, according to a study to be published in the March 9 Journal of the American Medical Association. Surveying users of an early physician order-entry system at a 750-bed teaching hospital from 1997 to 2004, researchers identified 22 sources of medication-errors facilitated by the system itself. The error sources fell into two broad categories: data fragmentation and human-machine interface problems. Data fragmentation problems principally reflected poor or inadequate integration of record-keeping systems -- for example, physicians complained of having to view up to 20 screens to see one patient's complete medication record. System crashes were the most common interface problem, but the category included any gap between system rules and actual work processes or behaviors.
Study co-author Brian Strom, associate vice president of strategic integration at the Hospital of the University of Pennsylvania, said the study doesn't mean computerized physician order-entry doesn't have a positive effect. "The point is ... it's not a one-shot deal," Strom said. "It needs to be continually evaluated, changed and reviewed." Read the article. -- by Joseph Conn