The impact of computerised physician order entry with integrated clinical decision support on pharmacist–physician communication in the hospital setting: a systematic review of the literature

Objective To document the issues and impact that computerised physician order entry (CPOE) with clinical decision support (CDS) can have on pharmacist–physician communication in the hospital setting. Hypothesis Novel processes introduced by CPOE systems with integrated CDS bring the potential to change face-to-face communication between the pharmacist and physician, and therefore affect their clinical interactions. The authors believe that virtual communications between healthcare providers and the content of CDS alerts may lead to a shift in traditional pharmacist–physician communications worthy of further study. Methodology MEDLINE, EMBASE and PubMed (1947–November 2011) were searched using subject headings and relevant free text terms. The language and date of publication were not defined. The studies were assessed for their quality, and the content of the articles was analysed in full and categorised to allow for a structured narrative review. Results A total of 48 papers were identified, of which 24 were excluded based on the title and abstract. Of the 24 papers reviewed in full text, seven were selected for inclusion. Several topics emerged from the review: computer entry: ‘a false communication’; interpersonal communication; the impact of pharmacist messages in an electronic format; physician accessibility to pharmacist alerts; and the effect of decision support on communication. Conclusions Few studies have examined the impact of CPOE and CDS technologies on pharmacist–physician communication in the hospital setting. Furthermore, there has been no research to date that looks specifically at how CDS affects what is communicated by pharmacists as alerts. Research into this area could provide a valuable insight into how communication channels in existing systems can be enhanced so that inter-professional interactions are optimised to benefit patient care.