CPOE saves lives. Well, sure, but more than that.

When I first read this article*, "Electronic medical orders may save lives," I thought it was a hold-over from five years ago. But, no, it is current. It suggests that this is the first time someone has been able to document that a computerized provider order entry (CPOE) system has saved lives in a pediatric setting.

I believe in evidence-based medicine and scientific studies, but this looks like a study with an overly limited outlook that may cause some people to question the value of CPOE. Sure it is great to save lives, but most medication errors don't kill people. Most of them result in increased morbidity, extended length of stay, or other things short of death.

In light of these facts, a quote like this in the article leaves me bewildered:

The debate over whether CPOE is working as intended is hardly over, said Menachemi: "I think it would be foolish to believe that any one study can end the discussion."

Let's go back to the basics. Hand-written drug orders are subject to transcription errors at both ends, the person writing them and the person reading them. Each time you add an intermediary in the drug ordering process, you add an opportunity for error. Also, unless there is real-time and accurate checking for drug-drug interactions, allergies, assessment of doses based on body weight and the like, there will be some percentage of preventable medication errors.

Maybe I live in a rarefied world of early CPOE adopters, but does anyone out there think this is still subject to debate? Instead, let's focus on enhancing the implementation process for CPOE, as well as maintaining the functionality of the systems that are installed. Check John Halamka's blog for commonly made mistakes on these fronts.

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*with thanks to e-Patient Dave.