Effects of computerized prescriber order entry on pharmacy order-processing time.

PURPOSE The effect of computerized prescriber order entry (CPOE) on the efficiency of medication-order-processing time was evaluated. METHODS This study was conducted at a 761-bed, tertiary care hospital. A total of 2988 medication orders were collected and analyzed before (n = 1488) and after CPOE implementation (n = 1500). Data analyzed included the time the prescriber ordered the medication, the time the pharmacy received the order, and the time the order was completed by a pharmacist. RESULTS The mean order-processing time before CPOE implementation was 115 minutes from prescriber composition to pharmacist verification. After CPOE implementation, the mean order-processing time was reduced to 3 minutes (p < 0.0001). The time that an order was received by the pharmacy to the time it was verified by a pharmacist was reduced from 31 minutes before CPOE implementation to 3 minutes after CPOE implementation (p < 0.0001). The implementation of CPOE reduced the order-processing time (from order composition to verification) by 97%. Additionally, pharmacy-specific order-processing time (from order receipt in the pharmacy to pharmacist verification) was reduced by 90%. This reduction in order-processing time improves patient care by shortening the interval between physician prescribing and medication availability and may allow pharmacists to explore opportunities for enhanced clinical activities that will further positively impact patient care. CONCLUSION CPOE implementation reduced the mean pharmacy order-processing time from composition to verification by 97%. After CPOE implementation, a new medication order was verified as appropriate by a pharmacist in three minutes, on average.

[1]  D. Bates,et al.  Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. , 1998, JAMA.

[2]  C. McDonald,et al.  A computerized reminder system to increase the use of preventive care for hospitalized patients. , 2001, The New England journal of medicine.

[3]  Jeffery R. Jensen.  The Effects of Computerized Provider Order Entry on Medication Turn-around Time: A Time-to-first Dose Study at the Providence Portland Medical Center , 2006, AMIA.

[4]  D. Bates,et al.  Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. , 2003, Archives of internal medicine.

[5]  D. Coplen.  Types of Unintended Consequences Related to Computerized Provider Order Entry , 2007 .

[6]  Hagop S. Mekhjian,et al.  Immediate benefits realized following implementation of physician order entry at an academic medical center. , 2002, Journal of the American Medical Informatics Association : JAMIA.

[7]  G. Kuperman,et al.  Computer Physician Order Entry: Benefits, Costs, and Issues , 2003, Annals of Internal Medicine.

[8]  Martha L. Lehman,et al.  Physician Order Entry impact on drug turn-around times , 2001, AMIA.

[9]  Paul N. Gorman,et al.  Computerized physician order entry in U.S. hospitals: results of a 2002 survey. , 2003, Journal of the American Medical Informatics Association : JAMIA.

[10]  Rainu Kaushal,et al.  Technology Evaluation: Return on Investment for a Computerized Physician Order Entry System , 2006, J. Am. Medical Informatics Assoc..

[11]  J. Marc Overhage,et al.  Research Paper: A Randomized Trial of "Corollary Orders" to Prevent Errors of Omission , 1997, J. Am. Medical Informatics Assoc..

[12]  Jonathan M. Teich,et al.  The impact of computerized physician order entry on medication error prevention. , 1999, Journal of the American Medical Informatics Association : JAMIA.