This study determined that an automated adverse drug event (ADE) surveillance system captured higher event rates than did existing voluntary systems, particularly in a community setting. Investigators implemented a custom-built computerized system with potential events undergoing review by medication safety pharmacists to estimate causality and severity. Not only did the system detect ADEs at higher rates in the community setting, but the specific events (eg, antibiotic-associated colitis, drug-induced hypoglycemia, and anticoagulation-related ADEs) were also more common in that setting. A past study was the first to demonstrate the value of real-time computerized analysis in tracking ADEs. This study builds on those findings by being one of the first to study such systems in a community hospital setting.