Test and monitor
Another recommendation from the Leapfrog Group: Incorporate rules on monitoring, testing, and fixing system flaws into federal meaningful use requirements. Also, monitor for missed alerts at least monthly and perform a root cause analysis any time there is a medication error.
Good Shepherd has used CPOE in its emergency department since January 2005. The organization looks at quality and performance metrics, medication error rates, percentage of verbal orders, and the numbers of completed orders, says Short. "We're looking at a lot of metrics to ensure what we're doing is on target," he says.
Also important is the need for flexible systems that allow users to quickly and easily make changes, such as updating medication lists with the click of a mouse when the FDA issues a black box warning, for example.
"If you can't keep CPOE systems up to date and take drugs off, put drugs on, change formularies, change dosing—just really manage them—you could introduce errors, because things do change," says Rose.
Leapfrog's Binder notes that, when done right, CPOE can reduce medication errors by up to 80%, an "enormous value" for the healthcare system.