Variable Success Rates Demonstrated by Pediatric Drug Error Prevention Systems

The combination of computerized physician order entry (CPOE) and clinical decision support (CDS) programs are meant to provide a robust safeguard against improper medication dosing in the pediatric population, but a new study suggests that the use of such systems within an electronic health record (EHR) have varied results.

Using the Leapfrog Group’s CPOE evaluation tool, investigators studied to evaluate how successful CPOE and CDS are at identifying medication orders that could potentially cause harm in a sample of 41 pediatric hospitals.

“We sought to evaluate the state of CPOE implementation in pediatric settings, but also to assess whether use of the CPOE evaluation tool could motivate further improvement within a given institution,” investigators wrote in the study, published in the Journal of the American Medical Informatics Association.

According to their findings, although pediatric CPOE systems were able to identify 62 percent of potential medication errors in the test scenarios, they ranged from 23 percent to 91 percent in the hospitals studied, according to a Health Data Management assessment of the results.

Principal investigator Juan Chaparro, MD, suggests that the variability points not to the EHR vendor providers are using, but to the implementation of a vendor product.

“Scores for hospitals that had implemented systems over 12 years were not significantly higher than those that implemented within the last year or two. It’s very dependent on the hospitals to make the effort to implement their clinical decision support. And while some hospitals performed admirably, there were significant laggards in overall scores,” Chaparro said, according to Health Data Management.

He said they were surprised to find no correlation between how long a hospital had had a system in place with the rates of errors detected.

Mary Butler is the associate editor at The Journal of AHIMA.

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