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Letters
July 13, 2005

Computerized Physician Order Entry Systems and Medication Errors—Reply

Author Affiliations
 

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;294(2):178-181. doi:10.1001/jama.294.2.180

In Reply: Our primary intent was to expand discussions about CPOE systems to more balanced analyses. CPOE systems will be central components of health care systems and a more judicious view of their potential weaknesses can only strengthen them.

As several letters noted, the CPOE system we studied was old and has since been replaced. However, it represents a widely used system that was continually updated and improved, even during its tenure at the hospital; it was not a historical artifact from the 1990s. Regardless, the question of whether our new system (or any other) has addressed the concerns raised in our article requires empirical investigation. As part of our ongoing work, we are now studying this newer system in actual practice rather than in the design laboratory. Our article focused on the problems of systems integration, clinical and organizational workflow, unanticipated responses (side effects) to enhancements, and human-machine interfaces. It is thus unlikely that new systems have addressed all of the issues identified in our article, as claimed by Drs Keillor and Morgenstern. Without evidence, there is no basis for the assertion that new CPOE systems have eliminated such problems.

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