News Feature | April 18, 2016

CPOE Adoption Hampered By Errors

Katie Wike

By Katie Wike, contributing writer


Doctors aren’t willing to put their faith in computerized physician order entry when errors are still plaguing such systems, reports a study from Leapfrog.

Computerized physician order entry (CPOE) is a system which seeks to eliminate errors. As JAMIA once noted, “CPOE can substantially reduce the frequency of medication errors in inpatient acute-care settings.”

Unfortunately, errors are still occurring at an alarming rate — a Leapfrog Group study found hospitals are not adopting these systems and CPOE is often missing critical errors within the medical record.

According to EHR Intelligence, these systems failed to flag 39 percent of potentially harmful and 13 percent of potentially fatal orders. Researchers looked closely at the CPOE systems of 1750 hospitals across the country. The most commonly unflagged errors related to medications and dosing were:

  • Diagnosis (e.g., prescribing a beta blocker to a patient with asthma),
  • kidney function (e.g., a drug that must be processed by the kidneys given to a patient with impaired kidney function without reducing the dose accordingly), and
  • monitoring (e.g., the failure to display a reminder to test drug levels after issuing a medication, when such follow-up is clinically indicated).

Standard CPOE use requires hospitals show the system alerts physicians to at least 50 percent of common, serious prescribing errors and whose physician order at least 75 percent of inpatient medication orders through a CPOE system, according to researchers.

“Using these combined criteria, nearly two-thirds of hospitals (64 percent) fully met the standard, showing a considerable improvement compared to 14% in 2010,” reads the report. “However, some hospitals (4 percent) still reported that they did not have an inpatient CPOE system at all.”

Leapfrog says some hospitals did not report any data at all. This unwillingness, according to researchers, only hampers other hospitals from being able to test their medication safety tools to identify areas for improvement.