TY - JOUR
T1 - The unintended consequences of computerized provider order entry
T2 - Findings from a mixed methods exploration
AU - Ash, Joan S.
AU - Sittig, Dean F.
AU - Dykstra, Richard
AU - Campbell, Emily
AU - Guappone, Kenneth
N1 - Funding Information:
This paper is based on a presentation given at MedInfo 2007. This work was supported by grant LM06942 and training grant ASMM10031 from the U.S. National Library of Medicine, National Institutes of Health. The funding agency had no role in development of this paper and none of the authors has conflicts to declare. All authors contributed to data gathering, analysis, and writing.
PY - 2009/4
Y1 - 2009/4
N2 - Objective: To describe the foci, activities, methods, and results of a 4-year research project identifying the unintended consequences of computerized provider order entry (CPOE). Methods: Using a mixed methods approach, we identified and categorized into nine types 380 examples of the unintended consequences of CPOE gleaned from fieldwork data and a conference of experts. We then conducted a national survey in the U.S.A. to discover how hospitals with varying levels of infusion, a measure of CPOE sophistication, recognize and deal with unintended consequences. The research team, with assistance from experts, identified strategies for managing the nine types of unintended adverse consequences and developed and disseminated tools for CPOE implementers to help in addressing these consequences. Results: Hospitals reported that levels of infusion are quite high and that these types of unintended consequences are common. Strategies for avoiding or managing the unintended consequences are similar to best practices for CPOE success published in the literature. Conclusion: Development of a taxonomy of types of unintended adverse consequences of CPOE using qualitative methods allowed us to craft a national survey and discover how widespread these consequences are. Using mixed methods, we were able to structure an approach for addressing the skillful management of unintended consequences as well.
AB - Objective: To describe the foci, activities, methods, and results of a 4-year research project identifying the unintended consequences of computerized provider order entry (CPOE). Methods: Using a mixed methods approach, we identified and categorized into nine types 380 examples of the unintended consequences of CPOE gleaned from fieldwork data and a conference of experts. We then conducted a national survey in the U.S.A. to discover how hospitals with varying levels of infusion, a measure of CPOE sophistication, recognize and deal with unintended consequences. The research team, with assistance from experts, identified strategies for managing the nine types of unintended adverse consequences and developed and disseminated tools for CPOE implementers to help in addressing these consequences. Results: Hospitals reported that levels of infusion are quite high and that these types of unintended consequences are common. Strategies for avoiding or managing the unintended consequences are similar to best practices for CPOE success published in the literature. Conclusion: Development of a taxonomy of types of unintended adverse consequences of CPOE using qualitative methods allowed us to craft a national survey and discover how widespread these consequences are. Using mixed methods, we were able to structure an approach for addressing the skillful management of unintended consequences as well.
KW - Attitude to computers
KW - Hospital information systems
KW - Physician order entry
KW - User-computer interface
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U2 - 10.1016/j.ijmedinf.2008.07.015
DO - 10.1016/j.ijmedinf.2008.07.015
M3 - Article
C2 - 18786852
AN - SCOPUS:62749180291
SN - 1386-5056
VL - 78
SP - S69-S76
JO - International Journal of Medical Informatics
JF - International Journal of Medical Informatics
IS - SUPPL. 1
ER -