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Journal Article > Review
The effect of computerized physician order entry on medication prescription errors and clinical outcome in pediatric and intensive care: a systematic review.
van Rosse F, Maat B, Rademaker CMA, van Vught AJ, Egberts ACG, Bollen CW. Pediatrics. 2009;123:1184-1190.
Computerized provider order entry (CPOE) continues to be hailed as a solution to preventing medication errors. While past research demonstrates its benefits in reducing serious medication errors, debate exists about its clinical benefits and unintended consequences. This systematic review builds on the existing literature by examining the impact of CPOE in pediatric and intensive care settings. Investigators analyzed data from twelve studies and discovered that medication prescription errors are in fact reduced after CPOE adoption. However, evidence of clinical benefit remains lacking, and the authors conclude that the quality of the implementation process is the key factor in success.
Journal Article > Study
Potential safety gaps in order entry and automated drug alerts: a nationwide survey of VA physician self-reported practices with computerized order entry.
Spina JR, Glassman PA, Simon B, et al. Med Care. 2011;49:904-910.
In contrast to most hospitals and clinics, the Veterans Affairs (VA) health care system has had a fully electronic health record with computerized provider order entry for several years. In this survey, VA physicians generally had positive impressions of the system, with nearly 90% feeling the system improved drug safety and nearly half reporting that serious drug interaction warnings were "very useful." However, the accuracy of drug–drug interaction and allergy warnings within this system are partially dependent upon clinicians manually entering medications prescribed by non-VA providers. As more than one quarter of respondents admitted to not always entering this data, this study highlights the importance of medication reconciliation in establishing accurate medication lists in the ambulatory care setting.