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Computerized drug ordering systems: Effective, yet with problems

It takes a considerable amount of time for some medical studies to be fully evaluated following completion of research and material findings.

Such is the case with a study on medication error published recently in the Journal of the American Medical Informatics Association (JAMIA). Because the research was based on work done by multiple medical bodies and also scrutiny of myriad other studies, there is a bit of time disconnect between its February 2013 publishing date and its focus on medication mistakes occurring in American hospitals in 2008.

Nonetheless, the study is revealing for its snapshot view of drug errors in medical facilities across the country as well as for its discussion of the now advanced trend of computerized provider order entry (CPOE) systems introduced to reduce medication problems. Further, the statistics it supplies can be extrapolated to the present and considered in light of the steadily increasing employment of CPOE processes in hospitals across the country.

What researchers noted foremost is the need to reduce in-house prescribing errors, which many diverse sources, including the Institute of Medicine (IOM), say is rampant. In fact, the IOM estimates that a typical hospital patient is on the receiving end of at least one medication mistake every day while hospitalized.

CPOE systems have been shown to greatly reduce such error, with JAMIA researchers saying that about 17 million fewer medication mistakes -- in ordering, transcribing, dispensing and monitoring -- occurred in 2008 compared to previous years owing to the increased adoption of computerized ordering.

There is a flip side to that, though, as has been acknowledged by many medical commentators and also, sadly, by a number of dire outcomes associated with the CPOE technology.

Specifically, and as noted in a recent media story on CPOE systems, computerized entry itself "can introduce new opportunities for medication errors." Those include doctors and staff members entering the wrong drug from drop-down menus, linking medication with the wrong patient, entering duplicate orders, providing incorrect dosing information, and failing to update patient status.

Those errors have had fatal consequences and point to a central fact about CPOE systems: They are of tremendous utility, but must be carefully managed.

Source: Pharmacy Times, "Computerized drug order systems lead to millions fewer hospital medication errors," Daniel Weiss, March 20, 2013

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Breslin and Breslin, PA, Donald A. Caminiti, Esq., was one of six law firms selected by the Attorney General of the State of New Jersey to act as special counsel to represent it in its lawsuit against the tobacco industry to recover Medicaid and other health related costs incurred by the state resulting from tobacco related illnesses.