CPOE Hard-Stop Alerts Have LimitationsOCTOBER 13, 2010
In continuing coverage, CMIO.com featured a computerized physician order entry (CPOE) study from Penn. An electronic nearly hard-stop alert in an inpatient CPOE system seems extremely effective in changing prescribing. However, this intervention precipitated clinically important treatment delays in four patients who needed immediate drug therapy. Brian L. Strom, MD, director of the Center for Clinical Epidemiology and Biostatistics, and colleagues conducted a randomized controlled trial to evaluate the effectiveness of a nearly "hard-stop" CPOE prescribing alert. The alert was intended to reduce concomitant orders for warfarin and trimethoprim-sulfamethoxazole. "We can't just put a system in place and assume it's going to help people. The key concept to realize is that these programs are interventions and, like any interventions, they can have side effects. We need to pay attention to those side effects and make sure there's a beneficial balance between them and their benefits," he said.