title: Effects of computerized physician order entry on medication turnaround time and orders requiring pharmacist intervention.
abstract: BACKGROUND
  Previous studies have demonstrated that computerized physician order entry (CPOE) of prescriptions reduces both turnaround time (TAT) and medication errors. However, these studies have been performed primarily in large academic centers with a relatively small number of medication orders. As such, many studies investigating the impact of CPOE on the level of pharmacist intervention have yielded conflicting results.
  
  
  OBJECTIVE
  The objective of this study was to examine the effects of CPOE on medication order TAT and the frequency of medication orders requiring pharmacist intervention in a community-based medical center.
  
  
  METHODS
  A prospective cohort study was conducted at a community-based medical center. A total of 24,767 prescriptions written for 940 patients over a six-month period were stratified into CPOE or non-CPOE (handwritten) cohorts. TAT between cohorts were tested using analysis of variance and Tukey's Honestly Significant Difference test. The number of orders requiring pharmacist intervention was compared between cohorts and tested using chi-square test or Fisher's exact test. Medication orders requiring pharmacist intervention were stratified by patient characteristics, therapeutic class, and types of medication error.
  
  
  RESULTS
  Medication orders not using CPOE were approximately 8 times more likely to require pharmacist intervention (2.26% versus 0.29%; P < 0.001), with the majority of pharmacist interventions performed to prevent medication errors. The overall mean TAT for medication orders was significantly shorter in the CPOE group in comparison with the non-CPOE group (22.2 ± 86.5 min versus 81 ± 256.7 min; P < 0.001). CPOE orders nearly eliminated medication errors with wrong dosage forms and formulary issues.
  
  
  CONCLUSIONS
  Medication orders entered via CPOE are associated with a significant reduction in medication TAT and less likely to require pharmacist intervention. Use of CPOE may improve quality of patient care and efficiency of health care delivery.
authors.affiliation: Somerset Medical Center, Somerville, NJ, USA.
authors.forename: Lloyd
authors.initials: L
authors.lastname: Davis
authors.affiliation: Somerset Medical Center, Somerville, NJ, USA; Ernest Mario School of Pharmacy Rutgers, the State University of New Jersey, Piscataway, NJ, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: Brunetti
authors.affiliation: School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea.
authors.forename: Eui-Kyung
authors.initials: EK
authors.lastname: Lee
authors.affiliation: College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, South Korea.
authors.forename: Nari
authors.initials: N
authors.lastname: Yoon
authors.affiliation: College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, South Korea.
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Cho
authors.affiliation: College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, South Korea. Electronic address: dongsuh75@gmail.com.
authors.forename: Dong-Churl
authors.initials: DC
authors.lastname: Suh
mesh_terms: D000368:Aged; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D008510:Medication Systems, Hospital; D008875:Middle Aged; D010595:Pharmacists; D010820:Physicians; D011446:Prospective Studies; D011787:Quality of Health Care
keywords: Adverse drug event; Computerized physician order entry; Medication error; Medication turnaround time; Pharmacist intervention