Restricted accessResearch articleFirst published online 2009-05
Early Adopters of Computerized Physician Order Entry in Hospitals That Care for Children: A Picture of US Health Care Shortly After the Institute of Medicine Reports on Quality
Objective. To determine national estimates of computerized physician order entry (CPOE) use for 2003 in hospitals that care for children. Design. Retrospective cohort analysis. Results. Six percent of the hospitals used CPOE (119 out of 2145). Children's hospitals are more likely to use CPOE than a children's unit (odds ratio [OR] = 6; 95% confidence interval [CI] = 1.5-23.9). Private for-profit hospitals are more likely to use CPOE than public hospitals (OR = 26.5; 95% CI = 3.1-224.8). Urban teaching hospitals are more likely to use CPOE than rural hospitals (OR = 3.9; 95% CI = 1.7-8.8). Hospitals in the Northeast, Midwest, and South are more likely to use CPOE than hospitals in the West (OR = 11.2, 95% CI = 4.8-26.5; OR = 4.2, 95% CI = 1.7-10.5; OR = 3.1, 95% CI = 1.5-6.3, respectively). Conclusions. In 2003, 6% of the hospitals that care for children reported using CPOE. Early adoption of CPOE was associated with children's hospitals, private hospitals, urban-teaching hospitals, and hospitals outside of the western region.
Kohn LT, Corrigan J, Donaldson MS, eds.; Committee on Quality of Health Care in America, Institute of Medicine. To Err Is Human: Building a Safer Health System. Washington, DC: National Academies Press; 2000.
2.
Committee on Quality of Health Care in America, Institute of Medicine.Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001.
3.
Poon EG, Blumenthal D., Jaggi T., Honour MM, Bates DW, Kaushal R.Overcoming barriers to adopting and implementing computerized physician order entry systems in U.S. hospitals. Health Aff ( Millwood). 2004;23:184-190. Citing: Advisory Board Company.Computerized Physician Order Entry: Lessons from Pioneering Institutions. Washington, DC: Advisory Board Company; 2001.
HimssUser Guide and Data Dictionary Final-December2003Release. Chicago, IL: Sheldon I. Dorenfest.
6.
Ash JS, Gorman PN, Seshadri V., Hersh WRComputerized physician order entry in U.S. hospitals: results of a 2002 survey . J Am Med Inform Assoc. 2004;11:95-99.
7.
Lindenauer PK , Ling D., Pekow PS, et al. Physician characteristics, attitudes, and use of computerized order entry. J Hosp Med. 2006;1:221-230.
8.
Poon EGUniversal acceptance of computerized physician order entry: what would it take? J Hosp Med. 2006; 1:209-211.
9.
Cutler DM, Feldman NE, Horwitz JR. U.S. adoption of computerized physician order entry systems. Health Aff (Millwood). 2004;24:1654-1663. Citing: First Consulting Group. Computerized Physician Order Entry: Costs Benefits and Challenges. Long Beach, CA: First Consulting Group; 2003.
10.
Mullett CJ, Evans RS, Christenson JC, Dean JMDevelopment and impact of a computerized pediatric antiinfective decision support program. Pediatrics. 2001;108:E75.
11.
King WJ, Paice N., Rangrej J., Forestell GJ, Swartz R.The effect of computerized physician order entry on medication errors and adverse drug events in pediatric inpatients. Pediatrics. 2003;112(3, pt 1):506-509.
12.
Potts AL, Barr FE, Gregory DF, Wright L., Patel NRComputerized physician order entry and medication errors in a pediatric critical care unit. Pediatrics. 2004; 113(1, pt 1):59-63.
13.
Holdsworth MT, Fichtl RE, Raisch DW, et al. Impact of computerized prescriber order entry on the incidence of adverse drug events in pediatric inpatients . Pediatrics. 2007;120:1058-1066.
14.
Walsh KE, Adams WG, Bauchner H., et al. Medication errors related to computerized order entry for children . Pediatrics. 2006;118:1872-1879.
15.
Han YY, Carcillo JA, Venkataraman ST, et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics . 2005;116:1506-1512.
16.
Shamliyan TA , Duval S., Du J., Kane RLJust what the doctor ordered. Review of the evidence of the impact of computerized physician order entry system on medication errors. Health Serv Res. 2008;43(1, pt 1):32-53.
17.
Poon EG, Jha AK, Christino M., et al. Assessing the level of healthcare information technology adoption in the United States: a snapshot. BMC Med Inform Decis Mak . 2006;6:1.
18.
Thompson TJ, Brailer DGThe Decade of Health Information Technology: Delivering Consumer-Centric and Information-Rich Health Care. Framework for Strategic Action, Office of the National Coordinator for Health Information Technology. Washington, DC: US Department of Health and Human Services ; 2004.
19.
The Leapfrog Group.Factsheet: Computer Physician Order Entry. Revision 2/21/07:1-4. Washington, DC: The Leapfrog Group.
20.
American Academy of Pediatrics.Uses of drugs not described in the package insert (off-label uses). Pediatrics. 2002;110(1, pt 1):181-183.
21.
Healthcare Cost and Utilization Project.Overview of the Kids' Inpatient Database (KID). Rockville, MD: Agency for Healthcare Research and Quality. http://www.hcup-us.ahrq.gov/kidoverview.jsp. Accessed July 5, 2008.
22.
Burke DE, Wang BB, Wan TT, Diana MLExploring hospitals' adoption of information technology. J Med Syst. 2002;26:349-355.
23.
Menachemi N., Burke D., Clawson A., Brooks RGInformation technologies in Florida's rural hospitals: does system affiliation matter? J Rural Health. 2005;21: 263-268.
24.
Merenstein D. , Egleston B., Diener-West M.Lengths of stay and costs associated with children's hospitals. Pediatrics. 2005;115:839-844.
25.
Rogers EMDiffusion of Innovations. 5th ed. New York, NY: Free Press; 2003.
26.
Kovach CR, Morgan S., Noonan PE, Brondino M.Using principles of diffusion of innovation to improve nursing home care. J Nurs Care Qual. 2008;23:132-139.
27.
Blumenthal D., DesRoches C., Donelan K., et al. Health Information Technology in the United States: Where We Stand, 2008. Executive Summary. http://www.rwjf.org/files/research/062508.hit.exsummary.pdf. Accessed July 5, 2008 .
28.
Parente ST, Van Horn RLValuing hospital investment in information technology: does governance make a difference? Health Care Financ Rev. 2006 ;28:31-43.
29.
Sittig DF, Ash JS, Zhang J., Osheroff JA, Shabot MMLessons from "Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system." Pediatrics . 2006;118: 797-801.
30.
Del Beccaro MA, Jeffries HE, Eisenberg MA, Harry EDComputerized provider order entry implementation: no association with increased mortality rates in an intensive care unit. Pediatrics. 2006;118:290-295.
