A Pragmatic Approach to Implementing Best Practices for Clinical Decision Support Systems in Computerized Provider Order Entry Systems

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First Review

This article was published in 2007 in Journal of American Medical Informatics Association. It represents the summary of all discussionss at conference on CDS in CPOE held in San Francisco, California, June 21–22, 2005.


The authors admit that implementation of clinical decision support (CDS) within computerized provider order entry (CPOE) systems can be difficult and expensive. However, many healthcare facilities still choose to go through this process. The justifiable reason is that CPOE with CDS can significantly reduce medication errors. [1]

Technical Issues

The conference addressed the following issues related to medication ordering and safety:

  • Reconciling the history of drug allergies electronically, which should be the key priority.
  • Drug–drug interaction checking.
  • Providing patients with computer-stored educational information about their prescriptions.

The participants of the discussion agree a CPOE system that is well-designed and fully implemented as part of EMR can have a great effect on providers satisfaction.

Non-technical Issues

The authors argue that socio-technical issues in a CPOE implementation project are also important. The progress of the project should be guided by continuous refinement of the system based on ongoing end-user feedback. In order for the project to be successful, careful planning and executing are needed.


Conference participants pointed out that barriers can be significant. However, a successful approach will involve leadership and administration that provide adequate financial support. It is also important to identify and involve strong champions. There must be appropriate support for workflows, fast system response times and reliability.


I agree that socio-technical issues in CPOE implementation should be given as much attention as technical issues. Clinicians are reluctant to embrace a change, especially if the change disrupts their workflows. Clear communication of goals and progress is needed.

Second Review

Enter second review here

Related Papers

Computerized physician order entry with clinical decision support in the long-term care setting


  1. P.A.Gross, MD, D.W.Bates, MSc. A Pragmatic Approach to Implementing Best Practices for Clinical Decision Support Systems in Computerized Provider Order Entry Systems. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2215068/pdf/25-S1067502706002076.main.pdf