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PSNet: Patient Safety Network
Journal Article

Return on investment for vendor computerized physician order entry in four community hospitals: the importance of decision support.

Zimlichman E, Keohane C, Franz C, et al. Joint Commission journal on quality and patient safety. 2013;39:312-8.

The uptake of computerized provider order entry (CPOE) in community hospitals has been slow due to difficulties associated with implementation and uncertainty about its real-world performance. One recent study demonstrated that commercial CPOE systems can effectively prevent adverse drug events (ADEs) in community hospitals. This follow-up study sought to establish the business case for CPOE through calculating the hospitals' return on investment (ROI)—accounting for the costs saved by preventing ADEs in relation to the cost of buying and implementing the system. Perhaps the study's greatest utility is that it provides data on the actual implementation costs of CPOE in the community setting, but the ROI for hospitals was modest at best and was actually negative at some hospitals. The authors note that the CPOE system in question had minimal decision support capabilities and even a small increase in ADE prevention via decision support would have improved the ROI. Findings from this study demonstrate that economic evaluation of safety strategies is urgently needed.