Wall Street Journal Examines ‘Decision Support’ Prescription Order Entry Systems
The Wall Street Journal on Wednesday examined the impact of a recent study that analyzed the effect of computerized order entry systems on medical errors at the Veterans Administration Medical Center in Salt Lake City. According to the Journal, the study finds that the VA's CPOE system was able to eliminate mistakes from illegible handwriting and could offer simple advice, such as avoiding drug interactions, but it was not "designed to provide more sophisticated advice on drugs, dosages and patient-monitoring strategies that might have averted harm." The study highlights "strikingly high numbers of adverse drug events" at the hospital, despite the CPOE system, the Journal reports.
According to the Journal, the VA study and another recent report that found "many potential glitches" in a CPOE system at a University of Pennsylvania hospital "seem to" contradict earlier research that found CPOE systems can reduce adverse drug events. However, the two studies could provide insight into which CPOE system "decision-support" mechanisms are most effective, the Journal reports. The VA study says that the high rates of adverse drug events likely will continue without the implementation of CPOE systems that "provide more than just rudimentary decision support on medications and treatment."
Since researchers collected the data for the study, the VA hospital has been developing an upgrade with support tools to help physicians choose drugs and doses. Carolyn Clancy, director of the Agency for Healthcare Research and Quality -- which funded the University of Pennsylvania study -- said, "We can't improve safety until we see what the problems are, and these studies are showing us that we still have a lot to learn."
Jonathon Teich, an assistant professor of medicine at Harvard University and chief medical officer at medical information technology company Healthvision, said, "The computer can remember all the thousands of little details and bring the right detail to your attention at the right time" (Landro, Wall Street Journal, 6/1).