ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2014
Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
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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.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Digital Health Technology Interventions for Improving Medication Safety: Systematic Review of Economic Evaluations.Journal of medical Internet research · 2025Pooled it
- How intervention studies measure the effectiveness of medication safety-related clinical decision support systems in primary and long-term care: a systematic review.BMC medical informatics and decision making · 2024Pooled it
- Implementation costs of hospital-based computerised decision support systems: a systematic review.Implementation science : IS · 2023Pooled it
- Individualized versus standardized risk assessment in patients at high risk for adverse drug reactions (IDrug) - study protocol for a pragmatic randomized controlled trial.BMC family practice · 2016Trial
- Evaluation of the Medication Never Events and Related Factors: A Nationwide Database Study.Advanced biomedical research · 2026Article
- Evaluating the Wasfaty E-Prescribing Platform Against Best Practices for Computerized Provider Order Entry.Healthcare (Basel, Switzerland) · 2025Article
- Theory-informed process evaluation protocol to assess a rapid-access outpatient model of care in South East Queensland, Australia.BMJ open · 2025Article
- A balancing act: the promise and pitfalls of clinical decision support.Proceedings (Baylor University. Medical Center) · 2025Article
- A Practical Approach to Optimize Computerized Provider Order Entry Systems and Reduce Clinician Burden: Pre-Post Evaluation of Vendor-Derived "Order Friction" Data.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2023Article
- The Value of Electronic Health Records Since the Health Information Technology for Economic and Clinical Health Act: Systematic Review.JMIR medical informatics · 2022Review
- Medication safety knowledge, attitude, and practice among hospital pharmacists in tertiary care hospitals in Saudi Arabia: a multi-center study.Archives of public health = Archives belges de sante publique · 2021Article
- Limiting the number of open charts does not impact wrong patient order entry in the emergency department.Journal of the American College of Emergency Physicians open · 2020Article
- Economic impact of clinical decision support interventions based on electronic health records.BMC health services research · 2020Review
- Effectiveness of Best Practice Alerts for Potentially Inappropriate Medication Orders in Older Adults in the Ambulatory Setting.The Permanente journal · 2020Article
- Recent Advancement of Clinical Information Systems: Opportunities and Challenges.Yearbook of medical informatics · 2018Review
- Quality of Decision Support in Computerized Provider Order Entry: Systematic Literature Review.JMIR medical informatics · 2018Review
- Lessons Learned When Introducing Pharmacogenomic Panel Testing into Clinical Practice.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2017Article
- The Impact of Order Source Misattribution on Computerized Provider Order Entry (CPOE) Performance Metrics.Perspectives in health information managemen · 2017Article
- Personalization and Patient Involvement in Decision Support Systems: Current Trends.Yearbook of medical informatics · 2015Review
- Implementing Computerized Provider Order Entry in Acute Care Hospitals in the United States Could Generate Substantial Savings to Society.Joint Commission journal on quality and patient safety · 2015Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundComputerized provider order entry (CPOE) is the process of entering physician orders directly into an electronic health record. Although CPOE has been shown to improve medication safety and reduce health care costs, these improvements have been demonstrated largely in the inpatient setting; the cost-effectiveness in the ambulatory setting remains uncertain.
objectiveThe objective was to estimate the cost-effectiveness of CPOE in reducing medication errors and adverse drug events (ADEs) in the ambulatory setting.
methodsWe created a decision-analytic model to estimate the cost-effectiveness of CPOE in a midsized (400 providers) multidisciplinary medical group over a 5-year time horizon- 2010 to 2014-the time frame during which health systems are implementing CPOE to meet Meaningful Use criteria. We adopted the medical group's perspective and utilized their costs, changes in efficiency, and actual number of medication errors and ADEs. One-way and probabilistic sensitivity analyses were conducted. Scenario analyses were explored.
resultsIn the base case, CPOE dominated paper prescribing, that is, CPOE cost $18 million less than paper prescribing, and was associated with 1.5 million and 14,500 fewer medication errors and ADEs, respectively, over 5 years. In the scenario that reflected a practice group of five providers, CPOE cost $265,000 less than paper prescribing, was associated with 3875 and 39 fewer medication errors and ADEs, respectively, over 5 years, and was dominant in 80% of the simulations.
conclusionsOur model suggests that the adoption of CPOE in the ambulatory setting provides excellent value for the investment, and is a cost-effective strategy to improve medication safety over a wide range of practice sizes.
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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.