Washington Post Examines Study on Problems With Computerized Physician Order Entry Systems

The Washington Post on Tuesday examined a study published earlier this month in the Journal of the American Medical Association that identified common errors associated with a computerized physician order entry system (Boodman, Washington Post, 3/22).

For the study, researchers from the University of Pennsylvania School of Medicine tracked medical residents and attending physicians at the Hospital of the University of Pennsylvania from 2002 to 2004 as they used the Eclipsys TDS CPOE system. Researchers also surveyed 261 medical residents about their use of the system (California Healthline, 3/9).

The study found that on a weekly basis, incorrect doses were prescribed, patients did not receive medications in a timely manner due to computer problems and providers had difficulty determining which drugs patients were prescribed. Lead author Ross Koppel, a medical sociologist, said, "We are so enamored of the technology that we are not making it responsive to the way people work."

The system in the study has since been replaced by a "state-of-the-art system ... designed to address the types of human errors described in the study," according to Rick Mansour, the medical information officer at Eclipsys.

However, Koppel says some of the newer CPOE models he has examined "still have the same faults." According to the Koppel, some of the system flaws found in the study could be easily fixed through design alterations, while others reflect a mismatch between the system and the way physicians actually work.

Mark Leavitt, medical director of the Healthcare Information and Management System Society, said, "Hopefully, no one is regarding CPOE as being the silver bullet to the problem of medical errors. CPOE is one of the most difficult applications to create because it's the thing that can slow the physician down the most" (Washington Post, 3/22).