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Does CPOE Leapfrog Quality?

June 18, 2008
by vciotti
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A new report just released by the Leapfrog Group studied the correlation between CPOE and quality of care measurements in 1,680 hospitals. No surprise that, since Leapfrog published it, the results were positive, since CPOE was one of Leapfrog's 3 mandates several years ago, along with hospital-based intensivists and evidence-based referrals. The study's author, Ashish Jah, summed the results up thusly:  "The bottom line is that we found that hospitals that implement CPOE have higher quality of care and better mortality rates than hospitals that have not.”Â


However, very few will read the full article all the way to the bottom, where Ashish adds:Â "The reality is, I think, clearly to some extent it's about better hospitals that happen to have CPOE. The hospitals that are focused on quality and safety are more likely to invest in CPOE."


That part will not get quoted by HIS vendors selling CPOE, nor "consulting" firms implementing it. All you're hear from them is the positive correlation. Hats to Ashish for being so honest, and let's hope enough people read beyond the headlines to counter the inevitable partial quotes from the study that will be flooding the media and vendor press releases.


Anyone remember the study from Pittsburgh a year or so ago that found increased medication errors with CPOE and closed-loop medication systems? It seemed to be buried in the back pages of most publications, well behind ads for CPOE and EMRs. CPOE can undoubtedly improve many things in a hospital, such as script legibility; but might the staggering sums being spent to buy and implement high-end systems might yield even better results if spent on other things like hiring more nurses? Wish someone would study that and give us a balanced scorecard on the emperor's new IT clothes.


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