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Role of computerized physician order entry systems in facilitating medication errors

Authors

Koppel, R., Metlay, J. P., Cohen, A., Abaluck, B., Localio, A. R., Kimmel, S. E., Strom, B. L.

Journal

JAMA

Publication Date

2005 Mar 9

Volume

293

Issue

Pages

1197-203

HIT Description: Hospital computerized physician order entry (CPOE) system More info...
Purpose of Study: identify and quantify the role of CPOE in facilitating prescription error risks
Years of study: 2002-2003
Study Design: descriptive quantitative

Summary:

Settings: urban 750-bed tertiary care teaching hopsital
Intervention: structured interviews with house staff, pharmacists, nurses, nurse-managers, attending physicians, and information technology managers; real-time observations of staff interacting with the system; focus groups and surveys of housestaff
Evaluation Method: questionnaires, observation notes
Description: commercial CPOE system (TDS) with pre-Windows interfaces
Interoperability: integration with pharmacy and nurse medication lists only
Barriers: identified 22 previously unexplored medication-error sources facilitated by CPOE that fall into the categories of 1) information errors generated by fragmentation of data and failure to integrate the hospital's severe computer and information systems; and 2) human-machine interface flaws reflecting machine rules that do not correspond to work organization or usual behaviors

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