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American Journal of Medical Quality
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Full Implementation of Computerized Physician Order Entry and Medication-Related Quality Outcomes: A Study of 3364 Hospitals

Feliciano B. Yu, MD, MSHI, MSPH

Department of Pediatrics, School of Medicine, fyu{at}peds.uab.edu

Nir Menachemi, PhD, MPH

School of Public Health

Eta S. Berner, EdD

Department of Health Services Administration, School of Health Related Professions

Jeroan J. Allison, MD, MSEpi

Division of General Internal Medicine, School of Medicine

Norman W. Weissman, PhD

Department of Health Services Administration, School of Health Related Professions

Thomas K. Houston, MD, MPH

Division of General Internal Medicine, School of Medicine, University of Alabama at Birmingham

This study compares quality of care measures for hospitals with fully implemented computerized physician order entry (CPOE) systems with hospitals that have not fully implemented such a system. Using a cross-sectional design, this study linked hospital quality data from the Centers for Medicare and Medicaid Services to the Health Information Management Systems Society Analytics database, which contains hospital CPOE adoption information. Performance on quality measures was assessed using univariate and multivariate methods. In all, 8% of hospitals have fully implemented CPOE systems; CPOE hospitals were more frequently larger, not-for-profit, and teaching hospitals. After controlling for confounders, CPOE hospitals outperformed comparison hospitals on 5 of 11 measures related to ordering medications and on 1 of 9 nonmedication-related quality measures. Using a large sample of hospitals, our study found significant positive associations between specific objective quality indicators and CPOE implementation. (Am J Med Qual 2009;24:278-286)

Key Words: computerized physician order entry system • quality indicators • evaluation research • performance measurement • decision support systems • patient safety

This version was published on July 1, 2009

American Journal of Medical Quality, Vol. 24, No. 4, 278-286 (2009)
DOI: 10.1177/1062860609333626
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