Although computerized physician order-entry prescribing systems are thought to improve patient safety and outcomes, researchers at the Children's Hospital of Pittsburgh found that mortality rates actually increased at their facility after implementation of a "commercially sold" CPOE system.
According to a report in the December issue of Pediatrics, a journal of the American Academy of Pediatrics, the mortality rate rose to 6.57% (36 out of 548 patients who were admitted for specialized, tertiary-level care) during the five months after implementation, from 2.8% (39 of 1,394) during the 13 months prior to implementation.
The study took place between Oct. 1, 2001 and March 31, 2003, and the report states that the October 29, 2002, CPOE implementation did result in a significant reduction in harmful adverse drug events.
Nevertheless, the report also stated that it regularly took one to two minutes to enter an order compared with the few seconds it took to handwrite an order. Also, two physicians were sometimes needed at the patient's bedside: one to manage medical care and the other to enter orders into the computer. The authors wrote that, after CPOE implementation, "interactions between ICU team members have remained fundamentally altered."
"Our unanticipated finding suggests that when implementing CPOE systems, institutions should continue to evaluate mortality effects, in addition to medication error rates, for children who are dependent on time-sensitive therapies," the authors concluded.
Read the abstract at: http://pediatrics.aappublications.org/cgi/content/abstract/116/6/1506