computerized physician order entry in the emergency department
TRANSCRIPT
Study Decrease in Medication Error
Comments
Bates et al, 1999 81% Typical medications: antibioticsanalgesics
anticoagulantselectrolytes
Bates et al, 1998 57%
Sard et al, 2008 90%
Aronsky et al, 2007 91%
King et al, 2003 40% CHEO (SCM)
Upperman et al, 2005 Avoid 1 ADE q20d Pre-post differences
Holdsworth et al, 2007 Avoid 1 ADE q64d Very small numbers
Inpatient Evidence
Study No CDS CDS P Value
Evans et al, 1994 77% 94% <0.001
Paul et al, 2006Concurrent
RCT57%64%
70%73%
<0.0010.03
Characteristic Pre-CPOE Post-CPOE P Value
Presence of a clinical question 34.8% 52.6% <0.0001
Information on prior diagnoses 51.1% 71.1% <0.01
Length (characters) 49.6 71.2 <0.05
Can CPOE make me smarter?
CDS functionalityAbxRenal dosingMedications in older patients
Improved communication to radiology
ED Evidence
Activity Time Pre-CPOE Time Post-CPOE P Value
Staff order entry 5 min 9.5 min 0.01
Resident order entry 5.5 min 14.3 min 0.001
RN-staff communication 24.5 min 13.3 min 0.01
Can CPOE improve ED flow?
Characteristic Pre-EMR/CPOE Time Post-EMR/CPOE Tme Pre-Post Difference
ED LOS 6.69 hrs 4.75 hrs 116 min
Lab turnaround time 2.03 hrs 1.44 hrs 35 min
X-ray turnaround time 55 min 44 min 11 min
CT turnaround time 3.64 hrs 1.74 hrs 114 min
Investigation Turnaround Times
Study Test Turnaround Time (min) Difference (min)
Pre-CPOE Post-CPOE
Guss et al, 2008Na
CBCTnI
46.742.241.8
37.236.330.6
9.55.9
11.2
Westbrook et al, 2008 35 25 10
Westbrook et al, 2006 73.8 58.3 15.5