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Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system

Authors

Han, Y. Y., Carcillo, J. A., Venkataraman, S. T., Clark, R. S., Watson, R. S., Nguyen, T. C., Bayir, H., Orr, R. A.

Journal

Pediatrics

Publication Date

2005 Dec

Volume

116

Issue

Pages

1506-12

HIT Description: EHR, CPOE More info...
Purpose of Study: assess the effect of CPOEon outcomes in a pediatric hospital
Years of study: 2001-2003
Study Design: time series
Outcomes: mortality rates

Summary:

Settings: University-affiliated 235 bed regional pediatric referral center with 12,000 annual admissions
Intervention: commecially available CPOE added on to existing medical information technology platform
Evaluation Method: risk-adjusted mortality rate determined by review of medical records
Description: PowerOrders; Cerner, a commercially sold "add-in" to an existing system (Millenium; Cerner)
Strategy: 3 months prior to CPOE implementation, all hospital health care personnel were trained with a mandatory 3 hour computer tutorial and practice session. Hospital-wide implementation occurred over a 6-day period, experts were available to provide hand-on consultations for a brief period of time, followed by telephone support
Quality of Care and Patient Safety Outcome: Risk-adjusted mortality increased form 2.80% (average) in the 4 quarters prior to CPOE implementation to 6.57% (average) in the 2 quarters after implementation.

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