Computerized physician order entry in the critical care and general inpatient setting: a narrative review.
Computerized physician order entry (CPOE) is an increasingly used technologic tool for entering clinician orders, especially for medications and laboratory and diagnostic tests. Studies in hospitalized patients, including critically ill patients, have demonstrated that CPOE, especially with decision support, improves several outcomes. These improved outcomes include clinical measures such as reductions in serious medication errors and enhanced antimicrobial management of critically ill patients resulting in reduced length of stay. Additionally, several process outcomes have improved with CPOE such as increased compliance with evidence-based practices, reductions in unnecessary laboratory tests and cost savings in pharmacotherapeutics. Future studies are needed to demonstrate the benefits of more patient specific decision support interventions and the seamless integration of CPOE into a wireless, computerized medication administration system.
Rothschild
Jeffrey
J
Division of General Medicine and Primary Care, Department of Medicine Brigham and Women's Hospital, 1620 Tremont St, Boston, MA, USA. jrothschild@partners.org
D002986:Clinical Trials as Topic; D003201:Computers; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D011307:Drug Prescriptions; D006751:Hospital Information Systems / Q000458:organization & administration*; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units / Q000458:organization & administration*; D019300:Medical Errors / Q000379:methods / Q000517:prevention & control; D016347:Medical Records Systems, Computerized; D008510:Medication Systems, Hospital / Q000458:organization & administration