Pediatric Informatics: Computer Applications in Child Health (Health ...

Chapter 26
Prescribing/Ordering: Computerized Order
Entry and Decision Support
Christoph U. Lehmann and George R. Kim
Objectives
To define computerized provider order entry (CPOE) and clinical decision
support (CDS)
To outline their function in pediatric medication use safety
To guide questions pediatric clinicians should ask during CPOE selection
To discuss briefly pediatric issues and challenges in CPOE implementation
26.1 Introduction
Institutional adoption of computerized provider order entry (CPOE) and clinical
decision support (CDS) has been advocated by the Institute of Medicine (IOM)
and others to reduce and prevent medication prescribing errors as part of a global
approach to safety (Table 26.1) 1 that includes: fostering an open, nonpunitive, and
goal-directed culture and environment for learning and teaching safety improvement,
understanding, and anticipating human behaviors and limitations, training
and working as a team, and creating robust systems for anticipating and handling
the unexpected.
26.2 Definitions
Computerized Provider Order Entry (CPOE, also called POE, Computerized
Physician Order Entry or Care Provider Order Entry) is the component of a clinical
information system that allows prescribers to enter clinical orders directly into a
computer for electronic processing and transmission to appropriate departments
and/or individuals for completion. Ambulatory CPOE (ACPOE) may connect
C.U. Lehmann et al. (eds.), Pediatric Informatics: Computer Applications 335
in Child Health, Health Informatics,
© Springer Science + Business Media, LLC 2009