Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems -- Radley et al. -- Journal of the American Medical Informatics Association

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Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems -- Radley et al. -- Journal of the American Medical Informatics Association

J Am Med Inform Assoc doi:10.1136/amiajnl-2012-001241

• Research and applications

Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems

1. David C Radley1,
2. Melanie R Wasserman2,
3. Lauren EW Olsho2,
4. Sarah J Shoemaker2,
5. Mark D Spranca2,
6. Bethany Bradshaw3

+ Author Affiliations

1. ¹Institute for Healthcare Improvement, Cambridge, Massachusetts, USA
2. ²US Health Division, Abt Associates Inc, Cambridge, Massachusetts, USA
3. ³School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA

1. Correspondence to Dr Lauren Olsho, US Health Division, Abt Associates, Inc, 55 Wheeler St, Cambridge, MA 02138, USA; lauren_olsho@abtassoc.com

• Received 2 August 2012
• Revised 19 December 2012
• Accepted 10 January 2013
• Published Online First 20 February 2013

Abstract

Objective Medication errors in hospitals are common, expensive, and sometimes harmful to patients. This study's objective was to derive a nationally representative estimate of medication error reduction in hospitals attributable to electronic prescribing through computerized provider order entry (CPOE) systems.

Materials and methods We conducted a systematic literature review and applied random-effects meta-analytic techniques to derive a summary estimate of the effect of CPOE on medication errors. This pooled estimate was combined with data from the 2006 American Society of Health-System Pharmacists Annual Survey, the 2007 American Hospital Association Annual Survey, and the latter's 2008 Electronic Health Record Adoption Database supplement to estimate the percentage and absolute reduction in medication errors attributable to CPOE.

Results Processing a prescription drug order through a CPOE system decreases the likelihood of error on that order by 48% (95% CI 41% to 55%). Given this effect size, and the degree of CPOE adoption and use in hospitals in 2008, we estimate a 12.5% reduction in medication errors, or ∼17.4 million medication errors averted in the USA in 1 year.

Discussion Our findings suggest that CPOE can substantially reduce the frequency of medication errors in inpatient acute-care settings; however, it is unclear whether this translates into reduced harm for patients.

Conclusions Despite CPOE systems’ effectiveness at preventing medication errors, adoption and use in US hospitals remain modest. Current policies to increase CPOE adoption and use will likely prevent millions of additional medication errors each year. Further research is needed to better characterize links to patient harm.