What is Computerized Physician Order Entry?

Christina Whyte
Christina Whyte
A laptop used for CPOE.
A laptop used for CPOE.

Computerized physician order entry (CPOE) systems allow physicians to enter orders for patient medications into a computer rather than write them by hand. The goals of CPOE are to reduce medication errors by having a computer program alert the prescribing physician if there is a harmful medication interaction and also identify other potential problem with the order. Computerized physician order entry is a term that can be misleading since other medical staff members, such as nurse practitioners, can also be granted authority to use CPOE systems.

Computerized physician order entry systems are a type of Clinical Decision Support System (CDSS) and are often paired with other CDSS systems for comprehensive computerized clinical support. These systems help medical staff make accurate diagnoses and follow clinically recommended steps for the treatment and care of patients with various needs. When used effectively, they can make medical practitioners' jobs easier, make workflow more efficient, and help patients receive optimum care. These systems can also integrate with electronic health records to maintain an ongoing continuity of care record for a particular patient.

Medication errors result in many patient deaths each year, and can also cause adverse reactions that range from the minor to the disabling. The aim of computerized physician order entry is to ensure that patients do not receive medication that is wrong or dangerous for them. This is particularly useful and important for patients who have complex medication needs, such as cancer patients or patients with AIDS. These patients may be taking many different medications with widely varying dosage schedules, and even minor changes in medications can have serious consequences. Using a CPOE system also means that important medical decisions are not affected by a staff member's ability to decipher another person's handwriting.

Medical facility staff members are often be resistant to change and learning new technology, so installing a computerized physician order entry system in a new environment may be challenging. Time is in short supply in almost all medical settings, and it can be difficult to make the time for training and getting used to the new system. The workflow of the whole facility may be changed, drastically for some staff members, and this can result in a period of misunderstandings and frustration as everyone attempts to modify their daily routine.

CPOE systems and other computer systems used in medicine are constantly evolving to become better and more efficient. One of the main concerns with computerized physician order entry systems, as well as with all computerized support systems, is that they can be overly restrictive of doctors' decisions. Clinical decision making is very complex and based on the past experience of the doctor as well as medical research. While CPOE systems can protect patients from poor decisions, they can also restrict doctors from prescribing medication that could be risky but is clinically justified.

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    • A laptop used for CPOE.
      By: Thomas Jansa
      A laptop used for CPOE.