1. Development of a Computerized Physician Order Entry (CPOE) System
Mark Rafalko
Michael Landau
Wallace Title

2. Problem Statement
In 1999 between 44,000-98,000 people died due to medical errors1
Drug error rate before 2000 was around 10-20%3
Large portion were human errors during prescription ordering
Drug-drug conflicts
Drug-food conflicts
Drug-allergy conflicts
Other forms of error:
Missing information, incorrect information, wrong dose, illegible, and non-formulary
Can we reduce the number of medical errors using a computerized system?
How do we design it so that people will use it?

3. Project Assessment
Already CPOE systems being used in ~5% of hospitals nationwide
Vanderbilt Hospital
Improved to 0.02% error rate at Vanderbilt2
Where have current systems failed?
Not intuitive
Require > 3 months of training
System-wide replacements
Don’t conform to user’s preferences

4. Project Assessment Things application will verify:
We are treating correct patient
Dosage
Frequency
Patient conflicts
Allergies
Food
Conflicts with other medications

5. Project Goals
Develop a web-based CPOE system that is a stand alone product
Significantly decrease number of medical errors
Make the application intuitive and user-friendly
Significantly decrease training period

6. Solution Hospital workflow analysis
Contacts at Vanderbilt Hospital
Use to design efficient application
Account for all documentation
Make application personal and customizable
Favorites
Personal schedule/workflow
Design for efficient error checking

7. Completed Work eMEDS Workflow analysis Research current systems
Run by project advisors Patrick Harris and David Roth
Patrick has a liberal arts and marketing background
David has a masters in BME from Vanderbilt
Build on current html based system
Workflow analysis
Efficiency
Research current systems
What did people like?
Where can we improve?
Formulate ideas
Custom screen
Favorites

8. Current Work Create use cases Continuing to brainstorm new ideas
Describe functionality of web pages
Aid in design process
Aim for end of February completion
Continuing to brainstorm new ideas
Finalizing workflow analysis
Incorporating database
Drug information from the pharmaceutical medical packaging suppliers (PMS)
Medical records of patients from the Admissions/Discharge/Transfers (ADT) database
For any missing information we will research and fill in the blanks for important medications and the respective drug information

9. Future Work
Prototype page creation
Testing

10. References
To Err is Human: Building a Safer Health System. Institute of Medicine, John Lindo. Janet M. Corrigan, and Mella Donaldson, eds, National Academy Press, (1999).
Snyder, Bill. VUMC Honored for Reducing Medical Errors. The Reporter. Vanderbilt University Medical Center: December 20, 2002.
Kenneth Elie Bizovi, Brandon Beckley, Michelle McDade, Annette Adams, Andrew Zechnich and Jerris Hedges. The Effect of Computer-assisted Prescription Writing on Emergency Department Prescription Errors. Academic Emergency Medicine Volume 8, Number 5 499, 2001.