Computer physician order entry and the real world: we're only humans. Jt Comm J Qual Saf 2004 Jun;30(6):342-6
Date
06/24/2004Pubmed ID
15208984DOI
10.1016/s1549-3741(04)30039-0Scopus ID
2-s2.0-4344668685 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
BACKGROUND: Computer physician order entry (CPOE) may have significant benefit to reducing medical errors in the hospital setting. The belief in the promise of CPOE has led organizations such as the Leap Frog Group to advocate for the implementation of CPOE in hospitals to improve patient safety. Human factors, or ergonomics, is the study of the interaction between humans and the systems and tools they use. It is unclear whether human factors principles have been applied to commercially available CPOE systems.
CONCLUSIONS: CPOE's true utility for preventing medical errors and harm is largely undetermined. The evidence that exists for error reduction with CPOE is in the setting of "homegrown" systems and not commercially available products. The cases portrayed in the two scenarios described in this article were drawn from actual events to illustrate how failure to attend to human factors and human-centered design can create or facilitate errors and harm.
RECOMMENDATIONS FOR ORGANIZATIONS IN IMPLEMENTING, CPOE: Organizations implementing CPOE or considering doing so could evaluate potential systems on the basis of evidence for human-centered design. An organization interested in addressing human factors issues as they relate to CPOE might, for example, familiarize itself with the basics of human factors, usability, and with existing evaluation methods for CPOE; involve the people who do the daily work in the evaluation and selection process; and ask potential vendors how they have addressed human factors in their CPOE systems.
Author List
Scanlon MAuthor
Matthew C. Scanlon MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Drug PrescriptionsEquipment Design
Ergonomics
Hospital Information Systems
Humans
Medication Errors
Medication Systems, Hospital
Physicians
Practice Patterns, Physicians'
United States