ABSTRACT
EMILY M. CAMPBELL, KENNETH P. GUAPPONE, DEAN F. SITTIG, RICHARD H. DYKSTRA, and JOAN S. ASH
18.1 INTRODUCTION
Health care providers use computerized provider order entry (CPOE) systems to place orders for medications, laboratory tests and other ancillary services. [1] CPOE has been shown to decrease medication ordering errors and redundant test ordering, promote practice standardization, and reduce overall healthcare costs. [2-4] Despite these benefits, CPOE systems have yet to be widely adopted for several reasons, including the high cost of implementation, clinician resistance to technology, worry regarding practice disruption and loss of productivity, fear of technology failure, and the inability of some CPOE implementations to integrate with existing healthcare systems. [5-7] Furthermore, there is evidence that unintended adverse consequences can surround the implementation and ongoing maintenance of these systems. [8-10] Recent, conflicting reports about the role of CPOE in the reduction of medication errors and associated costs have cast some doubt on the actual scale of improvements to be gained as CPOE systems have generated new kinds of medical errors, negatively affected patient outcomes, and resulted in higher overall medical costs for those institutions implementing them. [9,11-13] Thus, there remains a
need for ongoing analysis of CPOE to understand the causes of these issues and help find solutions.
