The Bush administration and many healthcare experts have spent recent years trying to encourage the healthcare industry to introduce electronic prescribing systems after reports of an increasing number of patient injuries and deaths caused by medical errors.
In an effort to combat prescribing errors and potentially save billions of dollars in annual costs, computerized physician order entry (CPOE) systems have been integrated in several hospitals.
However, a new study has emerged which has the potential to blow this theory out of the water.
The study, conducted by Ross Koppel and other researchers at the University of Pennsylvania School of Medicine, involved an investigation of house staff interaction with a CPOE system at a teaching hospital.
The results indicated that the CPOE system facilitated 22 types of medication error risks. These include fragmented CPOE displays that prevent a coherent view of medications, mistaking pharmacy inventory displays for dosage guidelines, computer-based communication failings and system crashes.
The authors concluded that most of these problems stemmed from poorly designed software that failed to recognize the workings of a hospital setting. Information on medications was also scattered all over the computer system.
In a bid to rescue the doubts which must inevitably arise from this announcement, the researchers remain positive about the benefits of computerized order systems as a way of eliminating errors associated with doctor’s handwriting.
They also make several recommendations on how to reduce medication errors, most of which focus on becoming less dependent on computers to improve healthcare.
They suggest that hospital staff should focus primarily on the organization of work and not on technology, and that perhaps the CPOE should only be used to determine clinical actions if they improve patient care.
Finally, hospitals and health centers should make arrangements to continuously revise and improve computer systems, keeping in mind that, as the researchers write, all changes generate new error risks.
The study supports another article in the journal, which looked at 100 trials of computer systems intended to assist the diagnosis and treatment of patients. This found that the appraisals of clinical decision support systems came primarily from technologists, while in fact, according to one of the editors, results from the research show that computerized patient information systems have not yet proven themselves.
Some physicians and technology experts have viewed the studies as too broad, because the technology is still developing and some of the computer systems reviewed were old. Meanwhile, David Bates, medical director for clinical and quality analysis in information systems at Partners HealthCare, voiced his concern in the Wall Street Journal that some hospitals may delay buying physician-order entry systems based on the studies.
