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j J Am Med Inform Assoc. 2004;11:104–112. DOI 10.1197/jamia.M1471. Medical error reduction is an international issue. The Institute of Medicine’s report on medical errors dramatically called attention to dangers inherent in the U.S. medical care system that might cause up to 98,000 deaths in hospitals and cost approximately $38 billion per year. In the(More)
OBJECTIVE To describe the kinds of unintended consequences related to the implementation of computerized provider order entry (CPOE) in the outpatient setting. DESIGN Ethnographic and interview data were collected by an interdisciplinary team over a 7 month period at four clinics. MEASUREMENTS Instances of unintended consequences were categorized using(More)
There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical(More)
j J Am Med Inform Assoc. 2005;12:8–12. DOI 10.1197/jamia.M1684. This report explores the gap between where we are now concerning adoption of the electronic health record (EHR), where American College of Medical Informatics (ACMI) members believe we should be, why the gap exists, and what can be done about it. The factors and forces influencing electronic(More)
OBJECTIVE To identify types of clinical unintended adverse consequences resulting from computerized provider order entry (CPOE) implementation. DESIGN An expert panel provided initial examples of adverse unintended consequences of CPOE. The authors, using qualitative methods, gathered and analyzed additional examples from five successful CPOE sites. (More)
Medical error reduction is an international issue, as is the implementation of patient care information systems (PCISs) as a potential means to achieving it. As researchers conducting separate studies in the United States, The Netherlands, and Australia, using similar qualitative methods to investigate implementing PCISs, the authors have encountered many(More)
OBJECTIVE To describe the perceived effect of computerized physician order entry (CPOE) on professional collaboration, workflow and quality of care. DESIGN Semi-structured interviews with experts involved in the design, implementation and evaluation of computerized physician order systems in the United States. MEASUREMENTS The interview transcripts were(More)
OBJECTIVE To describe the foci, activities, methods, and results of a 4-year research project identifying the unintended consequences of computerized provider order entry (CPOE). METHODS Using a mixed methods approach, we identified and categorized into nine types 380 examples of the unintended consequences of CPOE gleaned from fieldwork data and a(More)
Objective: To discover the extent and importance of unintended adverse consequences related to CPOE implementation in U.S. hospitals. Design, Setting, and Participants: Building on a prior qualitative study involving fieldwork at five hospitals, we developed and then administered a telephone survey concerning the extent and importance of CPOE-related(More)
In May of 2001, thirteen experts on computerized provider order entry (CPOE) from around the world gathered at a 2-day conference to develop a consensus statement on successful CPOE implementation. A qualitative research approach was used to generate and validate a list of categories and considerations to guide CPOE implementation.