Evaluation of the efficacy of enhanced computerised order entry (coe) with an embedded clinical decision support (cds) in a tertiary care hospital setting

Objective: Computerized order entry System (COE) with embedded clinical decision support (CDS) can check doses during prescription order entry along with the name of the drug, category, formulations available, indication, doses, drug interactions, contra-indications, side effects and special monitoring. The study was designed to develop a COE enhanced with CDS, to evaluate the efficacy and preconceived physicians’ attitude towards COE with CDS in a tertiary care hospital setting.
Method: The developed COE system with CDS was implemented in the hospital setting and totally 40 prescriptions were randomly selected from medical departments and analysed simultaneously by both COE with CDS and by the existing manual prescription order entry system. 40 physicians were randomly chosen and were oriented to the software initially and the preconceived physician’s attitude towards COE with CDS in comparison with the existing system of prescription auditing was assessed using the first part of Physician Order Entry User Satisfaction and Usage Survey (POESUS).
Results: COE with CDS was statistically more efficient in identifying the alerts when compared to the existing order entry system. The time taken by the COE with CDS was not significantly different from the time taken by the existing system (P= 0.79).90% physicians had an overall satisfaction on COE with CDS system, 95% felt an overall improvement in safety of patient care and 75% physicians felt that COE system saved their time.
Conclusion: This study suggests that implementation of COE with CDS could improve patient safety, reduce medication related problems and save physicians’ time.