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Massachusetts health care — wonky, with a healthy dose of reality

CPOE: No More Excuses

CPOE: No More Excuses

February 14, 2008

This morning, the MA Technology Collaborative and New England Healthcare Institute held an event to release a study on implementation in MA of Computerized Physician Order Entry (CPOE) systems. These systems replace the 19th century method of writing prescription orders, automating the order writing function and incorporating clinical decision support to avoid medication errors. They have been in place in many teaching hospitals for over a decade. The study examined how they could be implemented in a representative group of six MA community hospitals.

The findings show that CPOE saves lives and money. One in every 10 patients admitted to a MA community hospital suffers an adverse drug event, and 80% can be prevented by CPOE. The average community hospital would recoup costs of implementing CPOE within 26 months. If all 73 MA hospitals fully implemented CPOE, they could prevent 55,000 adverse drug events per year and save $170 million annually. (See today's front page Boston Globe coverage.) Click here for access to the full study.

How many hospitals in MA currently have these systems?

Ten.

Six were in this study, and we assume the other four are academic medical centers that have been at this for years. At this morning’s event, EOHHS Sect. JudyAnn Bigby said: “In healthcare we often know the right thing to do but take too long to actually do it.” She talked of her experience as a physician at Brigham & Women’s when they implemented CPOE 15 years ago. Dr. John Halamka describes Beth Israel Deaconess Medical Center’s embrace of CPOE. He offered to share at no cost BIDMC’s protocols with any community hospital to help them implement a robust CPOE system, saying “It’s not about competitive advantage. It’s about patient safety.”

Lynn Nicholas of the MA Hospital Association called for more carrots and fewer sticks in helping hospitals implement this reform. But Senator Dick Moore said: “The legislature now will not be as patient as it was when Oliver Wendell Holmes Jr. called upon doctors to wash their hands between patients, and we are still waiting for them to do it.” The Senator said predicted passage of legislation requiring full implementation of CPOE by every MA hospital by 10/1/2012. Dr. Robert Mandel of Blue Cross announced that Blue Cross will require hospital with which it contracts to have full CPOE by 2012 in order to receive quality incentive payments.

As Dr. Bigby noted, this is a familiar story – reforms proven to save money, protect patients and save lives, yet stymied by the culture. We are happy to see this reform moving forward. No more excuses.
James Madden