A new study published in the Journal of the American Medical Association says computerized physician order entry systems, which are implemented in part to reduce prescribing errors, can actually increase the risk of errors in certain situations.
So-called “adverse drug events” are estimated to injure or kill more than 770,000 patients in hospitals annually, the article says, and prescription errors are the most common cause. Previous studies have shown computerized order systems can eliminate errors due to misread handwriting, for example, but this study, by Russ Koppel, at the University of Pennsylvania School of Medicine, found that new kinds of errors can occur.
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The problems can be “easily corrected,” however, the article says, by tailoring technology to suit the work and improve patient care, “aggressively” examining how the systems are used, fixing problems promptly, and planning for continuous revisions and quality improvement. At Lifespan, which has almost completed implementation of a computerized physician order entry system at Rhode Island, Miriam and Newport hospitals, Dr. Reid Coleman, chief medical informatics officer, said the article is right on target about the perils of technology.
Because Lifespan was an early adopter of such systems, “we had to discover these issues ourselves,” Coleman said. “It would’ve been nice to have this paper in front of us.” But Lifespan also kept the system off-line, he said, until it had been tested extensively with doctors and nurses and adapted to suit their needs. It’s still not perfect, Coleman said – it’s “a little cumbersome” – but it’s free from the pitfalls identified in the Pennsylvania study.
