Computerized physician order entry and online decision support. 2004

Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
Department of Emergency Medicine, Northwestern University School of Medicine, Chicago, IL 60611, USA. jah505@northwestern.edu

Computerized physician order entry (CPOE) and decision support systems (DSS) can reduce certain types of error but often slow clinicians and may increase other types of error. The net effect of these systems on an emergency department (ED) is unknown. The consensus participants combined published evidence with expert opinion to outline recommendations for success. These include seamless integration of CPOE and DSS into systems and workflow; ensuring access to Internet-based and other online support material in the clinical arena; designing systems specifically for the ED and measuring their impact to ensure an overall benefit; ensuring that CPOE systems provide error and interaction checking and facilitate weight- and physiology-based dosing; using interruptive alerts only for the highest-severity events; providing a simple, vendor-independent interface for institutional customization of CPOE alert thresholds; maximizing the use of automated systems and passive data capture; and ensuring the widespread availability of CPOE and DSS using secure wireless and portable technologies where appropriate. Decisions regarding CPOE and DSS in the ED should be guided by the ED chair or designee. Much of what is believed to be true regarding CPOE and DSS has not been adequately studied. Additional CPOE and DSS research is needed quickly, and this research should receive funding priority. DSS and CPOE hold great promise to improve patient care, but not all systems are equal. Evidence must guide these efforts, and the measured outcomes must consider the many factors of quality care.

UI MeSH Term Description Entries
D011787 Quality of Health Care The levels of excellence which characterize the health service or health care provided based on accepted standards of quality. Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D004635 Emergency Medicine The branch of medicine concerned with the evaluation and initial treatment of urgent and emergent medical problems, such as those caused by accidents, trauma, sudden illness, poisoning, or disasters. Emergency medical care can be provided at the hospital or at sites outside the medical facility. Medicine, Emergency
D004636 Emergency Service, Hospital Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient. Emergency Outpatient Unit,Emergency Services Utilization,Hospital Emergency Room,Hospital Emergency Service,Hospital Emergency Services Utilization,Accident and Emergency Department,Emergency Departments,Emergency Hospital Service,Emergency Room,Emergency Units,Emergency Ward,Hospital Service Emergency,Service, Hospital Emergency,Department, Emergency,Departments, Emergency,Emergencies, Hospital Service,Emergency Department,Emergency Hospital Services,Emergency Outpatient Units,Emergency Room, Hospital,Emergency Rooms,Emergency Rooms, Hospital,Emergency Services, Hospital,Emergency Unit,Emergency Wards,Emergency, Hospital Service,Hospital Emergency Rooms,Hospital Emergency Services,Hospital Service Emergencies,Hospital Service, Emergency,Hospital Services, Emergency,Outpatient Unit, Emergency,Outpatient Units, Emergency,Room, Emergency,Room, Hospital Emergency,Rooms, Emergency,Rooms, Hospital Emergency,Service Emergencies, Hospital,Service Emergency, Hospital,Service, Emergency Hospital,Services Utilization, Emergency,Services Utilizations, Emergency,Services, Emergency Hospital,Services, Hospital Emergency,Unit, Emergency,Unit, Emergency Outpatient,Units, Emergency,Units, Emergency Outpatient,Utilization, Emergency Services,Ward, Emergency,Wards, Emergency
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D016347 Medical Records Systems, Computerized Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record. Automated Medical Records Systems,Computerized Medical Records Systems,Automated Medical Record System,Automated Medical Record Systems,Automated Medical Records System,Computerized Medical Record System,Computerized Medical Record Systems,Computerized Medical Records System,Computerized Patient Medical Records,Medical Record System, Automated,Medical Record System, Computerized,Medical Record Systems, Automated,Medical Record Systems, Computerized,Medical Records System, Automated,Medical Records System, Computerized,Medical Records Systems, Automated
D017751 Safety Management The development of systems to prevent accidents, injuries, and other adverse occurrences in an institutional setting. The concept includes prevention or reduction of adverse events or incidents involving employees, patients, or facilities. Examples include plans to reduce injuries from falls or plans for fire safety to promote a safe institutional environment. Hazard Management,Hazard Control,Hazard Surveillance Program,Safety Culture,Control, Hazard,Culture, Safety,Cultures, Safety,Hazard Controls,Hazard Surveillance Programs,Management, Hazard,Management, Safety,Program, Hazard Surveillance,Programs, Hazard Surveillance,Safety Cultures,Surveillance Program, Hazard,Surveillance Programs, Hazard
D019300 Medical Errors Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent. Medical Mistakes,Surgical Errors,Critical Incidents, Medical,Critical Medical Incidents,Errors, Medical,Errors, Surgical,Medical Error of Commission,Medical Error of Omission,Medical Errors of Commission,Medical Errors of Omission,Medical Mistake,Mistake, Medical,Mistakes, Medical,Never Event,Surgical Error,Wrong-Patient Surgery,Wrong-Procedure Errors,Wrong-Site Surgery,Commission Medical Error,Commission Medical Errors,Critical Incident, Medical,Critical Medical Incident,Error, Medical,Error, Surgical,Error, Wrong-Procedure,Errors, Wrong-Procedure,Event, Never,Events, Never,Incident, Critical Medical,Incident, Medical Critical,Incidents, Critical Medical,Incidents, Medical Critical,Medical Critical Incident,Medical Critical Incidents,Medical Error,Medical Incident, Critical,Medical Incidents, Critical,Never Events,Omission Medical Error,Omission Medical Errors,Surgeries, Wrong-Patient,Surgeries, Wrong-Site,Surgery, Wrong-Patient,Surgery, Wrong-Site,Wrong Patient Surgery,Wrong Procedure Errors,Wrong Site Surgery,Wrong-Patient Surgeries,Wrong-Procedure Error,Wrong-Site Surgeries
D020000 Decision Support Systems, Clinical Computer-based information systems used to integrate clinical and patient information and provide support for decision-making in patient care. Clinical Decision Support System,Clinical Decision Support Systems,Clinical Decision Support,Decision Support, Clinical,Clinical Decision Supports,Decision Supports, Clinical,Support, Clinical Decision,Supports, Clinical Decision

Related Publications

Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
January 2001, Radiographics : a review publication of the Radiological Society of North America, Inc,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
May 2011, Pediatrics,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
September 2014, The American journal of emergency medicine,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
May 2009, GMS health technology assessment,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
March 2016, Journal of the American Medical Informatics Association : JAMIA,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
January 2005, Journal of the American Medical Informatics Association : JAMIA,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
May 2010, International journal of medical informatics,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
January 1996, Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
September 2014, Academic radiology,
Jonathan A Handler, and Craig F Feied, and Kevin Coonan, and John Vozenilek, and Michael Gillam, and Peter R Peacock, and Rich Sinert, and Mark S Smith
June 2010, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists,
Copied contents to your clipboard!