CPOE and Medication Safety: State of the Art and State of the Practice

Jane Metzger, Principal Researcher, Emerging Practices, CSC, and David Classen, MD, Senior Partner, Healthcare Group, CSC. The adoption of CPOE isn’t pushed just to gain legible orders, but also because decision support can help alert physicians to, and help them avoid potential safety issues upfront as they are ordering. The Institute of Medicine, the National Quality Forum, and other national groups concerned about patient safety have included CPOE in their recommended safe practices in large part based on demonstrations by pioneering organizations that significant improvements in safety can be achieved when rules-based decision support aids in averting medication errors and adverse events by providing advice and warnings as physicians write orders in CPOE. More recently both CPOE and use of some medication-focused decision support in CPOE are elements of meaningful use that hospitals will need to demonstrate in order to qualify for the HITECH IT incentives. We will review recent evidence that sheds light on both what is possible (the state of the art) and what is common practice today (the state of the practice), as well as what we have observed that differentiates hospitals at either end of the spectrum.