When I first started my medical career, computers existed only in some research centers. Fast forward several years ( I’d rather not say how many years) and computers like it or not play a huge roll in medicine. Research into genomes for example, might have taken decades but with supercomputers millions of gene sequences can be determined in a reasonable amount of time. Searching the Internet for relevant research takes minutes rather than days or weeks waiting for articles to be mailed (not email). Apps which can make your Iphone into a stethoscope or even ultrasound machine exist. Finding an obscure drug is as easy as typing your name.
CPOE or computerized order entry is one of the programs, which had the promise of being better than apple pie. Instead of writing illegible prescriptions, wrong doses, wrong medications, this system with the power of computers would eliminate such errors- or so it was thought.
Problem is that the system was designed by humans and operated by humans so mistakes are bound to occur. How well does it work?
Well, two recent studies reveal mixed results: Some medical errors such as wrong dosing and administration of unauthorized drugs were in fact reduced. Others, such as time of drug administration were increased. One hospital in the study reported an almost 30% increased in medical errors!
From my experience in a busy ER it is all too easy to order medication on the wrong patient at the wrong time. Drugs which the patient is allergic to will prevent me from giving similar medication to the patient, which is a good thing. Overall though, I’m not overly impressed.
Down the road, I believe that medical programmers will in fact have to incorporate human behavioral patterns into these systems and build in more safeguards. Until then, I remain on high alert for unintended medical order errors.