ArticleJournal of the American Medical Informatics Association : JAMIA2014
Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two 'early adopter' hospitals.
Article in Journal of the American Medical Informatics Association : JAMIA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- How do stakeholders experience the adoption of electronic prescribing systems in hospitals? A systematic review and thematic synthesis of qualitative studies.BMJ quality & safety · 2019Pooled it
- A systematic review of the types and causes of prescribing errors generated from using computerized provider order entry systems in primary and secondary care.Journal of the American Medical Informatics Association : JAMIA · 2017Pooled it
- An appraisal of published usability evaluations of electronic health records via systematic review.Journal of the American Medical Informatics Association : JAMIA · 2017Pooled it
- Assessing Digital Maturity of Hospitals: Viewpoint Comparing National Approaches in Five Countries.Journal of medical Internet research · 2025Article
- Essential strategic principles for planning and developing digitally enabled interventions in health and care settings.BMC health services research · 2024Article
- Applying the Non-Adoption, Abandonment, Scale-up, Spread, and Sustainability Framework Across Implementation Stages to Identify Key Strategies to Facilitate Clinical Decision Support System Integration Within a Large Metropolitan Health Service: Interview and Focus Group Study.JMIR medical informatics · 2024Article
- Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review.Journal of medical Internet research · 2023Article
- Optimising ePrescribing in hospitals through the interoperability of systems and processes: a qualitative study in the UK, US, Norway and the Netherlands.BMC medical informatics and decision making · 2023Article
- Teaching Digital Medicine in a Virtual Classroom: Impacts on Student Mindset and Competencies.International journal of environmental research and public health · 2023Article
- Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis.BMJ open quality · 2023Article
- The Understanding of Medical Informatics among Dental and Medical Students.BioMed research international · 2022Article
- Guidance for publishing qualitative research in informatics.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Electronic Medication Management Systems: Analysis of Enhancements to Reduce Errors and Improve Workflow.Applied clinical informatics · 2021Article
- Physicians' Use of the Computerized Physician Order Entry System for Medication Prescribing: Systematic Review.JMIR medical informatics · 2021Review
- Digital Health in Physicians' and Pharmacists' Office: A Comparative Study of e-Prescription Systems' Architecture and Digital Security in Eight Countries.Omics : a journal of integrative biology · 2021Review
- Overview of digital health teaching courses in medical education in Germany in 2020.GMS journal for medical education · 2021Article
- Clinical Decision Support May Link Multiple Domains to Improve Patient Care: Viewpoint.JMIR medical informatics · 2020Article
- Article
- Developing and Applying a Formative Evaluation Framework for Health Information Technology Implementations: Qualitative Investigation.Journal of medical Internet research · 2020Article
- Theoretical and methodological considerations in evaluating large-scale health information technology change programmes.BMC health services research · 2020Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveTo understand the medium-term consequences of implementing commercially procured computerized physician order entry (CPOE) and clinical decision support (CDS) systems in 'early adopter' hospitals. MATERIALS AND
methodsIn-depth, qualitative case study in two hospitals using a CPOE or a CDS system for at least 2 years. Both hospitals had implemented commercially available systems. Hospital A had implemented a CPOE system (with basic decision support), whereas hospital B invested additional resources in a CDS system that facilitated order entry but which was integrated with electronic health records and offered more advanced CDS. We used a combination of documentary analysis of the implementation plans, audiorecorded semistructured interviews with system users, and observations of strategic meetings and systems usage.
resultsWe collected 11 documents, conducted 43 interviews, and conducted a total of 21.5 h of observations. We identified three major themes: (1) impacts on individual users, including greater legibility of prescriptions, but also some accounts of increased workloads; (2) the introduction of perceived new safety risks related to accessibility and usability of hardware and software, with users expressing concerns that some problems such as duplicate prescribing were more likely to occur; and (3) realizing organizational benefits through secondary uses of data.
conclusionsWe identified little difference in the medium-term consequences of a CPOE and a CDS system. It is important that future studies investigate the medium- and longer-term consequences of CPOE and CDS systems in a wider range of hospitals.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.