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1 July 2003 | Volume 139 Issue 1 | Pages 31-39
Several analyses have detected substantial quality problems throughout the health care system. Information technology has consistently been identified as an important component of any approach for improvement. Computerized physician order entry (CPOE) is a promising technology that allows physicians to enter orders into a computer instead of handwriting them. Because CPOE fundamentally changes the ordering process, it can substantially decrease the overuse, underuse, and misuse of health care services. Studies have documented that CPOE can decrease costs, shorten length of stay, decrease medical errors, and improve compliance with several types of guidelines. The costs of CPOE are substantial both in terms of technology and organizational process analysis and redesign, system implementation, and user training and support. Computerized physician order entry is a relatively new technology, and there is no consensus on the best approaches to many of the challenges it presents. This technology can yield many significant benefits and is an important platform for future changes to the health care system. Organizational leaders must advocate for CPOE as a critical tool in improving health care quality.
Author and Article Information
From Partners HealthCare System and Harvard Medical School, Boston, Massachusetts, and the Providence Health System, Portland, Oregon.
Acknowledgments: The authors thank Joan Ash, PhD, who organized a conference in 2001 to discuss factors that are important in the implementation of CPOE and stimulated the authors to consider the ideas presented in this paper. They also thank Anne Kittler for assistance in preparing the manuscript.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Gilad J. Kuperman, MD, PhD, Partners HealthCare System, 93 Worcester Street, 2nd Floor, Wellesley, MA 02481; e-mail, gkuperman{at}partners.org.
Current Author Addresses: Dr. Kuperman: Partners HealthCare System, Inc., 93 Worcester Street, 2nd Floor, Wellesley, MA 02481.
Dr. Gibson: Providence Health System, 11308 SW 68th Parkway, Portland, OR 97223. IMPROVING PATIENT CARE
Improving Patient Care is a special section within Annals supported in part by the U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ). The opinions expressed in this article are those of the authors and do not represent the position or endorsement of AHRQ or HHS.
Computer Physician Order Entry: Benefits, Costs, and Issues
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|
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|
|
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|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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|
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|
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