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Cases & Commentaries
- Web M&M
Annie Wong-Beringer, PharmD; December 2010
A patient on palliative chemotherapy was given intravenous vancomycin for methicillin-resistant staphylococcus aureus (MRSA), despite a rising creatinine level, and went into acute kidney failure.
Perspectives on Safety > Interview
Bar Coding for Medication Safety, September 2008
Eric G. Poon, MD, MPH, is Director of Clinical Informatics at Brigham and Women’s Hospital and Assistant Professor of Medicine at Harvard Medical School. Dr. Poon’s research has focused on using health information technology to improve patient safety. He oversees the development and implementation of clinical applications including computerized physician order entry (CPOE) and barcode-assisted electronic medication administration record, and was lead author on the first rigorous study demonstrating the impact of a bar coding system in a hospital pharmacy. We asked him to speak with us about how such technology can augment medication safety.
Journal Article > Study
Evaluation of laboratory monitoring alerts within a computerized physician order entry system for medication orders.
Palen TE, Raebel M, Lyons E, Magid DM. Am J Manag Care. 2006;12:389-395.
Increased use of computerized physician order entry (CPOE) systems has focused greater attention on integrating effective clinical decision support systems (CDSS) to modify prescribing behavior and reduce errors. This study randomized primary care physicians to receive specific laboratory monitoring alerts for a selected group of medications and compared their practices to a control group that received no CDSS. Investigators found no difference between the two physician groups. They discuss the tension between having too many reminders and effectively delivering important reminders. These findings mirror those of a past review that suggested the impact of CDSS on patient outcomes compared to the impact on care without CDSS remains unclear, with a need for better evaluative strategies.
Journal Article > Meeting/Conference Proceedings
Jha AK, Desroches CM, Campbell EG, et al. N Engl J Med. 2009;360:1628-1638.
Increasing the use of electronic health records (EHRs) is a major policy priority, as implementation has been slow both in the United States and in other countries. This survey of nearly 3000 US hospitals found that less than 2% had a fully functional EHR (defined as incorporating clinical documentation, laboratory and imaging results, computerized provider order entry, and clinician decision support). Survey respondents cited cost and maintenance considerations as major barriers to adopting EHRs, concerns that have been cited in prior research. Given that most outpatient practices also do not use electronic records, the authors recommend several policy initiatives to spur EHR implementation.