Computerized physician order entry (CPOE) systems are getting better, but still miss many dangerous or even fatal medication errors. That’s according to a Castlight Health analysis of data from the Leapfrog Group‘s national hospital survey.
According to the report, released Thursday on the last day of Medication Safety Week, CPOE systems failed to send alerts for 39 percent of potentially harmful drug orders in 2015. They also missed 13 percent of potentially fatal medication orders.
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These numbers represent a slight improvement over 2014, but progress has stagnated over the last five years, according to said Erica Mobley, director of communications and development for the Washington-based Leapfrog Group. “It’s concerning to see that,” Mobley said.
“Without accelerated improvement, patients will continue to receive medications or dosages that increase their risk of injury or death,” the Leapfrog-Castlight report stated.
As a result, Leapfrog — a coalition of large employers and other major purchasers of healthcare services — called for hospitals even with “well-functioning” CPOE to double- and triple-check orders.
“We would suggest that hospitals take a close look at their CPOE,” Mobley said. She recommended that hospitals should work with their health IT vendors and clinical leaders to improve medication reconciliation and avoid potential errors.
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It’s a tricky proposition, since too many alarms can lead to alert fatigue, causing physicians to tune out warnings or build dangerous workarounds, Mobley noted.
The report found that the vast majority of hospitals have medication reconciliation processes in place and also have measures of accountability. But sometimes they don’t add new treatments or guidelines to their CPOE systems, nor do they always ensure that medication lists are up to date, Mobley said.
On the bright side, 96 percent of all U.S. hospitals now meet Leapfrog’s standards for CPOE implementation. When the organization started its hospital survey in 2001, just 2 percent did.
“One of the real incredible improvements is the amount of hospitals implementing CPOE,” Mobley said. Many took the CPOE safety test for the first time in 2015, giving hope for a reduction in error rates in the near future. Mobley said errors typically fall in the second or third year of participation, after hospitals have had time to identify and fix process issues.
Photos: Flickr user Ministerio TIC Colombia, The Leapfrog Group
