OBJECTIVE It is the objective of this article to provide a guide to health care providers adopting computerized prescriber order entry (CPOE) and to explain recent developments of important concepts and initiatives such as "meaningful use" that will have significant impact on successful implementation of CPOE. The specific goals are to discuss key concepts relating to the NEW ARRA/HITECH-EHR meaningful use criteria and its relevance to CPOE Safe Practice and medication safety, summarize and update the recent scientific evidence evaluating CPOE, present the new 2010 CPOE safe practice, and suggest ways the CPOE safe practice may be expanded and harmonized with the new EHR meaningful use criteria. METHODS This article evaluates the latest published studies in the field of CPOE and reexamines the objectives, the requirements for achieving these objectives, and evidence of efficacy for this practice. It reviews relevant issues of medication safety, the likely impact of CPOE, the efficacy of CPOE in various studies, key measures of impact of the practice, and important implementation issues. The 2010 updates to the National Quality Forum CPOE practice are also reviewed with support from the evidentiary base. RESULTS This paper has presented an update to the National Quality Forum Safe Practice on CPOE for 2010. Although the practice itself has not changed, the scientific evidence of the impact of CPOE on medication safety and quality of care continues to accumulate. However, the adoption of CPOE by hospitals in the United States remains very low, as low as 6% in 1 study. CONCLUSIONS The adoption of CPOE has been low despite increasing evidence that hospital patients are still experiencing significant rates of preventable adverse drug events. This low adoption rate will likely be impacted by the new ARRA/HITECH legislation and the meaningful use concept.