Magazine article Drug Topics

It's Coming

Magazine article Drug Topics

It's Coming

Article excerpt


Electronic physician order entry yields benefits to New York hospital

Electronic physician order entry (POE) might not be a reality in your hospital yet, but it's probably only a matter of time. According to the Gartner Group, which provides technology assistance to organizations, some 10 states will have passed legislation by 2003 that requires hospitals to develop and implement a plan for reducing medical errors through automated order entry systems and other means. This legislation is based on a California law, passed last year, requiring hospitals in the state to do the same thing (Drug Topics, Nov 6,2000).

Montefiore Medical Center, Bronx, N.Y., is one health system that has taken the bull by the horns and installed POE. According to its unified director of pharmacy, John Manzo, Pharm.D., POE has demonstrated a return on investment (ROD for Montefiore by reducing its medication error rate and saving staff time. Manzo spoke at the recent Healthcare Information & Management Systems Society annual conference in New Orleans.

Montefiore phased in POE in 1999. So far, about 60% of the health system has gone on-line. About onethird of the doctors love POE, the same proportion hate it, and the balance say it's OK, Manzo told the audience. On the units where POE is up and running, paper orders are not accepted anymore, except when the system is down. Manzo said he has been extremely surprised by how compliant physicians are. He attributed this to the fact that Montefiore has a large house staff, so it's easier to make these physicians use POE than it is for private attendings who visit the hospital only a few times a month.

To what extent has POE reduced Montefiore's med errors? Manzo said his staff has been collecting data on the hospital's med error rate since 1997. Based on a review of thousands of orders pre- and post-POE, "about 50% or higher of prescribing errors on POE units have been eliminated," he declared. An automated system has helped staff minimize confusion over dosage strength, routes, decimals, dosage form, and brand and generic conversions, he explained. Given the press blitz on drug errors recently and payers' and patients' concern about this issue, Montefiore's new reduced incident rate is a "great marketing tool that we haven't begun to exploit," he observed.

The other major benefit of POE is a quicker drug turnaround time. Manzo said the time it takes to get orders filled and delivered to the floor was estimated pre- and post-- POE. …

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