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Report: Hospitals Increase CPOE Use, but Problems Still Exist

July 23, 2014
by Rajiv Leventhal
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The number of U.S. hospitals that are adopting computerized physician order entry (CPOE) systems to reduce medication errors is increasing, according to a report from the Washington, D.C.-based Leapfrog Group.

According to the 2013 Leapfrog Hospital Survey, which was prepared by the San Francisco-based Castlight Health, 43 percent of hospitals in 2013 met Leapfrog's standards for use of CPOE. Specifically, the survey showed 113 hospitals met Leapfrog's standards in 2009, compared with 616 in 2013.

Leapfrog says that its standard is aimed at ensuring that patients are being prescribed medications through a computerized order entry system that alerts prescribers to drug-drug interactions, drug-allergy interactions, and other potential prescribing errors, and requires that:

At least 75 percent of medication orders across all inpatient units are ordered through a CPOE system.

The hospital has tested the system to ensure that physicians are alerted to common, serious medication errors.

But some problems with performance of the systems persist, such as failure to alert on potentially fatal medication errors, the survey found. In 2013, CPOE systems did not alert physicians to one-third of the test orders that would have led to an adverse patient event. What’s more, the CPOE systems did not catch one in six of the test orders that would have resulted in death had the order been administered to a real patient. This failure rate is far too high, and points to the critical need for hospitals to make additional improvements to their medication ordering processes, the report’s authors stated.

“The stakes couldn’t be higher. Hospital errors remain the third leading cause of death in the U.S., so we want patients and purchasers to put safety first,” Leah Binder, president and CEO of Leapfrog said in a news release statement

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