Difference between revisions of "The vulnerabilities of computerized physician order entry systems: a qualitative study"
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== Aim== | == Aim== | ||
| − | #To test the vulnerabilities of various currently used [[Computerized physician order entry | computerized physician order entry systems (CPOEs)]] to different types of | + | #To test the vulnerabilities of various currently used [[Computerized physician order entry | computerized physician order entry systems (CPOEs)]] to different types of [[medication errors]]. |
| − | #To collect essential information for qualitative analysis that can help understand effective tactics and improve design and usability of CPOEs. | + | #To collect essential information for qualitative analysis that can help understand effective tactics and improve design and usability of CPOEs. |
==Methods== | ==Methods== | ||
| − | The following is a summary of | + | The following is a summary of methods used in this investigation <ref name="Slight 2015"> Slight, S. P., Eguale, T., Amato, M. G., Seger, A. C., Whitney, D. L., Bates, D. W., & Schiff, G. D. (2015). The vulnerabilities of computerized physician order entry systems: a qualitative study. Journal of the American Medical Informatics Association: JAMIA. http://doi.org/10.1093/jamia/ocv135</ref>. |
| − | *Reviewed a random sample of 63040 | + | *Reviewed a random sample of 63040 medication error reports from the US Pharmacopeia (USP) MEDMARX reporting system. |
*CPOE-contributed errors. | *CPOE-contributed errors. | ||
*Capable to be tested in current CPOE systems. | *Capable to be tested in current CPOE systems. | ||
| − | *To identify interface design, usability and workflow related issues. | + | *To identify interface design, usability and workflow related issues. |
| − | + | ||
== Results == | == Results == | ||
| − | *CPOE systems often failed to detect and prevent important | + | *CPOE systems often failed to detect and prevent important [[medication errors]]. |
*Variations of the means of alert generation. | *Variations of the means of alert generation. | ||
*High frequency of confused alerts. | *High frequency of confused alerts. | ||
*Unrelated warning display with current erroneous entry. | *Unrelated warning display with current erroneous entry. | ||
| − | *Delayed warnings for dangerous drug-drug interactions that did not display at the time of order entry. | + | *Delayed warnings for dangerous [[Drug-drug interaction|drug-drug interactions]] that did not display at the time of order entry. |
*Lack of [[Clinical decision support systems | clinical decision support (CDS)]] protections. | *Lack of [[Clinical decision support systems | clinical decision support (CDS)]] protections. | ||
*Unclear wording for warnings in some CPOEs. | *Unclear wording for warnings in some CPOEs. | ||
| Line 23: | Line 22: | ||
*High variability among different CPOE systems. | *High variability among different CPOE systems. | ||
*Healthcare organizations are probably not getting all the safety benefits that they presumably should have by using CPOE plus CDS. | *Healthcare organizations are probably not getting all the safety benefits that they presumably should have by using CPOE plus CDS. | ||
| − | *To change this scenario, design and implementation of an appropriately designed | + | *To change this scenario, design and implementation of an appropriately designed CDS system to improve effectiveness and usability of current CPOE systems could be one of effective tactics. In addition, human factors need to be carefully considered in this hybrid system as well. |
| − | + | ||
| + | ==Related Articles== | ||
| + | * [[Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems]] | ||
| + | *[[Factors contributing to an increase in duplicate medication order errors after CPOE implementation]] | ||
| + | *[[Can Utilizing a Computerized Provider Order Entry (CPOE) System Prevent Hospital Medical Errors and Adverse Drug Events?]] | ||
| + | *[[Role of computerized physician order entry systems in facilitating medication errors.]] | ||
==References== | ==References== | ||
| Line 33: | Line 36: | ||
[[Category: CPOE]] | [[Category: CPOE]] | ||
[[Category: CDSS]] | [[Category: CDSS]] | ||
| + | [[Category: Medication Errors]] | ||
Latest revision as of 04:26, 30 November 2015
Aim
- To test the vulnerabilities of various currently used computerized physician order entry systems (CPOEs) to different types of medication errors.
- To collect essential information for qualitative analysis that can help understand effective tactics and improve design and usability of CPOEs.
Methods
The following is a summary of methods used in this investigation [1].
- Reviewed a random sample of 63040 medication error reports from the US Pharmacopeia (USP) MEDMARX reporting system.
- CPOE-contributed errors.
- Capable to be tested in current CPOE systems.
- To identify interface design, usability and workflow related issues.
Results
- CPOE systems often failed to detect and prevent important medication errors.
- Variations of the means of alert generation.
- High frequency of confused alerts.
- Unrelated warning display with current erroneous entry.
- Delayed warnings for dangerous drug-drug interactions that did not display at the time of order entry.
- Lack of clinical decision support (CDS) protections.
- Unclear wording for warnings in some CPOEs.
Conclusions
- High variability among different CPOE systems.
- Healthcare organizations are probably not getting all the safety benefits that they presumably should have by using CPOE plus CDS.
- To change this scenario, design and implementation of an appropriately designed CDS system to improve effectiveness and usability of current CPOE systems could be one of effective tactics. In addition, human factors need to be carefully considered in this hybrid system as well.
Related Articles
- Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems
- Factors contributing to an increase in duplicate medication order errors after CPOE implementation
- Can Utilizing a Computerized Provider Order Entry (CPOE) System Prevent Hospital Medical Errors and Adverse Drug Events?
- Role of computerized physician order entry systems in facilitating medication errors.
References
- ↑ Slight, S. P., Eguale, T., Amato, M. G., Seger, A. C., Whitney, D. L., Bates, D. W., & Schiff, G. D. (2015). The vulnerabilities of computerized physician order entry systems: a qualitative study. Journal of the American Medical Informatics Association: JAMIA. http://doi.org/10.1093/jamia/ocv135
