A risk analysis method to evaluate the impact of a computerized provider order entry system on patient safety

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This article is to review of CPOE’s impact on patient safety. A quantitative evaluation was performed to show the impact on safety. The researchers designed a comparative risk analysis to measure the drug prescription process before and after the implementation of CPOE. [1]


The facilities of study, Geneva University Hospitals which is comprised of 2,200 beds, 5,000 health care providers. The facility covers a wide range of patient from in to out, primary to tertiary. Team to perform the analysis consisted of nurses, physicians, and a representative from the medical informatics department, pharmacist and a psychologist.

FMECA (Failure Modes, Effects and Criticality Analysis) Risk Analysis: is a methodology designed to identify potential failure modes for a product or process, to assess the risk associated with those failure modes, to rank the issues in terms of importance and to identify and carry out corrective actions to address the most serious concerns.


The process was divided into four steps: therapy selection and prescription modalities, formal prescription, order management, treatment and follow-up. To use quantitative criticality analysis, the analysis team considers the reliability/unreliability for each item at a given operating time and identifies the portion of the item’s unreliability that can be attributed to each potential failure mode. For each failure mode, they also rate the probability that it will result in system failure. The team then uses these factors to calculate a quantitative criticality value for each potential failure and for each item. Criticality Analysis indicated 27 identified failure modes 3813 for handwritten prescription. The major safety improvement was observed from errors that were due ambiguous, incomplete or illegible orders, wrong dose determination and interaction.


The impact of CPOE on safety of the patient depends strongly on the implementation functionality and ergonomics. The analysis was to evaluate the relationship between the system and the patient.


  1. Bonnabry, Pascal et al. “A Risk Analysis Method to Evaluate the Impact of a Computerized Provider Order Entry System on Patient Safety.” Journal of the American Medical Informatics Association : JAMIA 15.4 (2008): 453–460. PMC. Web. 4 Apr. 2015. http://dx.doi.org/10.1197/jamia.M2677