Table 1.

Studies Comparing CPOE to the Standard of Care.^14–23

Author	Year	Design	Interventiona	Findings
Graumlich et al14	2009	Randomized controlled trial	Discharge softwareb	No changes in patient satisfaction with discharge; improvement in outpatient provider perceptions of discharge quality; worsening of inpatient provider perception of time required to complete the discharge process
Graumlich et al15	2009	Randomized controlled trial	Discharge softwareb	No change in hospital readmissions, emergency department visits, or adverse events
Mir et al16	2009	Before/after analysis	CPOE	There was a 10-fold decrease in erroneous (missing, incomplete) prescription information
Leung et al17	2012	Before/after analysis	CPOE	Decreased preventable adverse drug events by 33%, but increased overall adverse drug events
van Doormaal et al18	2009	Before/after analysis	CPOE	Significant reduction in medication errors, but no change in preventable adverse drug events
King et al19	2003	Before/after analysis	CPOE	Significant decrease in medication errors, but not in adverse drug events
Devine et al20	2010	Before/after analysis	CPOE	Significant reduction in errors, especially of illegibility; no significant reduction in preventable adverse drug events
Collin et al21	2008	Before/after analysis	CPOE	The ordering of some tests (full blood counts, urea and electrolytes, and chest roentgenograms) was reduced, while the ordering of other tests (computed tomography under some circumstances) increased
Bartos et al22	2008	Before/after analysis	CPOE	All clinical providers—physicians, nurses, unit secretaries, physician extenders, and “other staff” who do not interact with CPOE directly—perceived themselves to be less powerful after CPOE implementation. All but the “other” category—all who interacted with CPOE—perceived it more negatively after implementation
Longhurst et al23	2010	Before/after analysis	CPOE	Mortality in the children’s hospital decreased by 20% (0.8%-40%) following implementation of CPOE

Abbreviations: CPOE, computerized physician order entry.

^a These studies all compared CPOE to the pre-CPOE, handwritten orders standard of care (except for the first 2). Of note, almost all CPOE systems, especially the more recent ones, incorporate varying amounts of clinical decision support, whether by the structure of the order entry itself or by the provisioning of order sets, clinical alerts, and other cues to encourage or discourage certain kinds of orders.

^b Both of these publications are about the same randomized trial. Of note, the intervention was a form of CPOE in that it generated a medication reconciliation, but not the comprehensive kind (ie, wherein providers can order any and all interventions from admission to discharge) commonly considered under the aegis of CPOE.