Approach for analysis of order check overrides in a computerized practitioner order entry system.

While it has been established that electronic order entry systems can prevent transcription errors and check orders for severe drug allergies and interactions, continuous monitoring of the effectiveness of order checks is important. The goal of this study is to examine the rate at which high severity order checks generated in the electronic medical record at VA Puget Sound are overridden by clinicians. We compare our results to those of a previous study that found high override rates for Critical Drug Inter-action and Allergy-Drug Interaction order check categories.

Preparation and use of preconstructed orders, order sets, and order menus in a computerized provider order entry system.

Objective: To describe the configuration and use of the computerized provider order entry (CPOE) system used for inpatient and outpatient care at the authors' facility.

Design: Description of order configuration entities, use patterns, and configuration changes in a production CPOE system.

Measurements: The authors extracted and analyzed the content of order configuration entities (order dialogs, preconfigured [quick] orders, order sets, and order menus) and determined the number of orders entered in their production order entry system over the previous three years.

Characteristics and override rates of order checks in a practitioner order entry system.

Order checks are important error prevention tools when used in conjunction with practitioner order entry systems. We studied characteristics of order checks generated in a sample of consecutively entered orders during a 4 week period in an electronic medical record at VA Puget Sound. We found that in the 42,641 orders where an order check could potentially be generated, 11% generated at least one order check and many generated more than one order check.