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Computerized Ordering of Medications and Other Tests in Doctor’s Offices Could Save Billions and Improve Patient Safety

This report shows that providers can save more than $3 billion annually and prevent medication-related injuries by using software systems for medication, diagnostic tests, and other medical services.

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April 21, 2004

If physicians and other providers in California used sophisticated, office-based software systems that support ordering of medications, diagnostic tests, and other medical services, they would save more than $3 billion annually and prevent nearly 250,000 medication-related injuries, according to a new study produced for the California HealthCare Foundation.

Prepared by the Center for Information Technology Leadership (CITL), the report includes estimates that widespread adoption of these systems in ambulatory (medical office) settings would save individual California providers about $29,000 a year in expenses. Additionally, entering important information directly into a computer would help providers, on average, prevent approximately nine adverse drug reactions each year.

Known as computerized order entry, or CPOE, these information systems are rapidly being adopted in hospitals across the country where medical and medication-related errors result in thousands of patient injuries and deaths each year. CPOE systems have been shown to reduce serious medication errors by more than 50%, increase compliance with care guidelines, and improve the use of diagnostic tests in inpatient settings. However, adoption of CPOE in ambulatory settings (ACPOE) has been much slower, according to the researchers.

"If implemented statewide, advanced ACPOE systems would provide Californians with a substantially safer health care system," said Douglas Johnston, a senior analyst for CITL.

The report, Patient Safety in the Physician's Office: Assessing the Value of Ambulatory CPOE, looks at the clinical, financial, and organizational benefits of adopting ACPOE in California. Key findings include:
  • Though advanced systems offer the best long-term clinical and financial returns, intermediate level systems would provide the best financial benefits in California during the first ten years of use. This is due to California’s lower rate of medication use, as compared to national averages.
  • Advanced ACPOE systems are expensive to implement and maintain. Providers bear the burden for these costs, but other health care stakeholders — payers and purchasers — get the lion’s share of financial benefits.
  • Nationally, the volume of outpatient visits is increasing dramatically; suggesting that information technology such as ACPOE could have a profound impact on health cost reduction and improved quality of care. Limitations in the design of the study and available data sources are described in the report. The projections for the report were based on software models developed by CITL for a report published in 2003, The Value of Computerized Provider Order Entry in Ambulatory Settings.

    The Center for Information Technology Leadership is a nonprofit, Boston-based research organization established in 2002 to guide the health care community in making more informed strategic IT investment decisions.

    The full report is available online through the link below.

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