Close
  • Latest News
  • Artificial Intelligence
  • Video
  • Big Data and Analytics
  • Cloud
  • Networking
  • Cybersecurity
  • Applications
  • IT Management
  • Storage
  • Sponsored
  • Mobile
  • Small Business
  • Development
  • Database
  • Servers
  • Android
  • Apple
  • Innovation
  • Blogs
  • PC Hardware
  • Reviews
  • Search Engines
  • Virtualization
Read Down
Sign in
Close
Welcome!Log into your account
Forgot your password?
Read Down
Password recovery
Recover your password
Close
Search
Logo
Logo
  • Latest News
  • Artificial Intelligence
  • Video
  • Big Data and Analytics
  • Cloud
  • Networking
  • Cybersecurity
  • Applications
  • IT Management
  • Storage
  • Sponsored
  • Mobile
  • Small Business
  • Development
  • Database
  • Servers
  • Android
  • Apple
  • Innovation
  • Blogs
  • PC Hardware
  • Reviews
  • Search Engines
  • Virtualization
More
    Home Latest News

      Health Tech Advance Can Lead to Errors

      Written by

      M.L. Baker
      Published March 8, 2005
      Share
      Facebook
      Twitter
      Linkedin

        eWEEK content and product recommendations are editorially independent. We may make money when you click on links to our partners. Learn More.

        Computerized systems that reduce certain medication errors increase the risk of others, concludes a study published Wednesday in the Journal of the American Medical Association.

        CPOE (computerized physician order entry) is widely hailed as an important solution for reducing medical errors. However, the study, led by Ross Koppel at the University of Pennsylvania, listed over twenty ways that CPOE made medical errors more likely to happen. In particular, medicines could be ordered for the wrong patient, sent to the wrong place, or delayed for more than 24 hours.

        Koppels original intention was not to study CPOE, but the sources of medical prescribing errors made by young physicians in hospitals. He told eWEEK.com he was surprised when the doctors kept bringing up the CPOE system, until he looked at it himself.

        “I shadowed people, and looked at the system, and interviewed them, and I understood what they meant. It was a clunky, clumsy system that could easily facilitate errors,” Koppel said.

        The problem is that vendors and administrators expect doctors to shape their practices to the software rather than the other way around, Koppel said. “[When] software doesnt work the way information flows in the hospital, they want doctors and hospital processes to wrap themselves like pretzels around the software.”

        /zimages/4/28571.gifA study shows that health care providers with access to EHRs (electronic health records) are more likely to have complete patient information. Click here to read more.

        Based on a survey of 88 percent of clinicians using the system, Koppels study found several ways CPOE could encourage errors, including several listed below.

        • If a physician enters orders after midnight, say after evening rounds, medication intended for the coming morning will not arrive until the next morning.
        • Names of patients are listed alphabetically in small font, making it easy to select the wrong patient.
        • Clinicians are unsure of patients medications because all medications cannot be shown on a single screen.
        • Some reminders are kept in paper charts and are often ignored, leading to gaps in medication.
        • Drug dosage levels displayed by the CPOE do not reflect guidelines, but pharmacy inventory.
        • Medications suspended for surgery must be re-entered and activated individually. Though nurses can change a patients status to “active,” this will not affect medications.
        • CPOE crashes and shut-downs delay orders and, if patients are moved to a different room when the system is out of service, cause medications to be sent to the wrong room.
        • When medical procedures are ordered, cancelled, or modified, all accompanying medicines must be stopped, re-ordered, or modified separately. Also, ordering non-standard drugs requires a separate process that may be ignored, causing delays.

        Though clinicians are ultimately responsible for clinical errors, Koppel said, clinical software must make it harder, not easier to make mistakes.

        He could not recall any improvements made to the system during the time of his study, from 2002 to 2004. “I saw doctors trying to work around the software and getting very frustrated that it hadnt been adjusted to make it responsive to their needs.”

        Nonetheless, Koppel said he was in favor of CPOE systems. “There are some dumb programs and really poor integrations, but on balance they reduce hand-writing errors, speed up orders and are instantly available from anywhere.”

        Next Page: Koppels study reflects an increasing awareness of IT issues in the health care sector.

        Study Reflects Increasing Awareness

        Though CPOE has been endorsed by high-profile groups like the Leapfrog Group, only about one in twenty U.S. hospitals have a system in place. Of those, fewer than half of physicians use the system for the majority of medication orders, according to information posted on the TEPR 2005 (Toward an Electronic Patient Record) Web site.

        Koppel said that vendors needed to be willing to investigate how their products were working in hospitals and to make “constant tweaks” to adjust the software to the clinicians, rather than the other way around. “Installing the software and teaching people how to use it is only the first of many, many steps.”

        Koppels study looked at an older CPOE system (Eclipsyss TDS) in one hospital, the University of Pennsylvania Health System. Rick Mansour, Eclipsyss Chief Medical Information Officer, said the company had already corrected flaws pointed out by the study in their latest product.

        “With the evolution of technology since the first-generation CPOE-based systems were developed, Eclipsys has incorporated numerous features into the design and build of its Sunrise Clinical Manager that dramatically reduce the potential for human errors.”

        Other vendors contacted by eWEEK.com were not immediately available for comment or said they could not comment because their system had not been evaluated.

        Two clinical informaticians contracted by eWEEK.com said the problems cited in Koppels study seemed universal.

        /zimages/4/28571.gifTo read Monya Bakers opinion about the promises and dangers of health IT, click here.

        “Physicians and nurses have been concerned about the new [kinds of] mistakes for a long time, and its great to see someone documenting on that,” said Russ Cucina, a practicing physician and professor at University of California, San Francisco.

        Joan Ash, a professor of medical informatics and clinical epidemiology at Oregon Health and Science University, has studied unintended consequences of CPOE in three different countries, and told eWEEK.com her research has come to many of the same conclusions.

        She said part of the problem was lack of awareness by those that pick the systems. Hospitals tend to get information from vendors and to hire consultants more inclined to study technical specifications than how a technology would fit into an organization.

        The study reflected an increasing and welcome consideration of how new tools work within health care organizations, she said. “I dont think anyone should be depressed by these results. I think its a wake up call, and a really good thing.”

        Cucina said that user interfaces for clinical systems have lagged far behind those of other commercial applications partly because the clinicians using the system were not the ones purchasing the systems, but also because of the hectic, unpredictable pace of a clinicians work.

        “The software is written from an engineering mentality where work is linear and uninterrrupted,” Cucina said, “but clinicians dont have linear, uninterrupted time.”

        /zimages/4/28571.gifCheck out eWEEK.coms for the latest news, views and analysis of technologys impact on health care.

        M.L. Baker
        M.L. Baker
        Monya Baker is co-editor of CIOInsight.com's Health Care Center. She has written for publications including the journal Nature Biotechnology, the Acumen Journal of Sciences and the American Medical Writers Association, among others, and has worked as a consultant with biotechnology companies.

        Get the Free Newsletter!

        Subscribe to Daily Tech Insider for top news, trends & analysis

        Get the Free Newsletter!

        Subscribe to Daily Tech Insider for top news, trends & analysis

        MOST POPULAR ARTICLES

        Artificial Intelligence

        9 Best AI 3D Generators You Need...

        Sam Rinko - June 25, 2024 0
        AI 3D Generators are powerful tools for many different industries. Discover the best AI 3D Generators, and learn which is best for your specific use case.
        Read more
        Cloud

        RingCentral Expands Its Collaboration Platform

        Zeus Kerravala - November 22, 2023 0
        RingCentral adds AI-enabled contact center and hybrid event products to its suite of collaboration services.
        Read more
        Artificial Intelligence

        8 Best AI Data Analytics Software &...

        Aminu Abdullahi - January 18, 2024 0
        Learn the top AI data analytics software to use. Compare AI data analytics solutions & features to make the best choice for your business.
        Read more
        Latest News

        Zeus Kerravala on Networking: Multicloud, 5G, and...

        James Maguire - December 16, 2022 0
        I spoke with Zeus Kerravala, industry analyst at ZK Research, about the rapid changes in enterprise networking, as tech advances and digital transformation prompt...
        Read more
        Video

        Datadog President Amit Agarwal on Trends in...

        James Maguire - November 11, 2022 0
        I spoke with Amit Agarwal, President of Datadog, about infrastructure observability, from current trends to key challenges to the future of this rapidly growing...
        Read more
        Logo

        eWeek has the latest technology news and analysis, buying guides, and product reviews for IT professionals and technology buyers. The site’s focus is on innovative solutions and covering in-depth technical content. eWeek stays on the cutting edge of technology news and IT trends through interviews and expert analysis. Gain insight from top innovators and thought leaders in the fields of IT, business, enterprise software, startups, and more.

        Facebook
        Linkedin
        RSS
        Twitter
        Youtube

        Advertisers

        Advertise with TechnologyAdvice on eWeek and our other IT-focused platforms.

        Advertise with Us

        Menu

        • About eWeek
        • Subscribe to our Newsletter
        • Latest News

        Our Brands

        • Privacy Policy
        • Terms
        • About
        • Contact
        • Advertise
        • Sitemap
        • California – Do Not Sell My Information

        Property of TechnologyAdvice.
        © 2024 TechnologyAdvice. All Rights Reserved

        Advertiser Disclosure: Some of the products that appear on this site are from companies from which TechnologyAdvice receives compensation. This compensation may impact how and where products appear on this site including, for example, the order in which they appear. TechnologyAdvice does not include all companies or all types of products available in the marketplace.

        ×