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March 9, 2005

Computer Technology and Clinical Work: Still Waiting for Godot

Author Affiliations

Author Affiliations: Department of Emergency Medicine, University of Florida, Jacksonville (Dr Wears); Clinical Safety Research Unit, St Mary’s Hospital, Imperial College, London, England (Dr Wears); and Department of Social Medical Sciences, Institute of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands (Dr Berg).

JAMA. 2005;293(10):1261-1263. doi:10.1001/jama.293.10.1261

Process-supporting information technology (IT) has been heralded as an important building block in attempts to improve the quality and safety of health care. Two areas in particular have drawn both attention and funding. The first is clinical decision support; that is, information systems designed to improve clinicians’ decision making. The second is computerized physician order entry (CPOE) as a means for reducing medication errors. The literature in these fields has been characterized by frequent reports of success, often accompanied by predictions of a bright new (and near) future; however, the future seems never to arrive. Behind the cheers and high hopes that dominate conference proceedings, vendor information, and large parts of the scientific literature, the reality is that systems that are in use in multiple locations, that have satisfied users, and that effectively and efficiently contribute to the quality and safety of care are few and far between.1

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