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Health political background Computerized physician order entry (CPOE) systems are software to electronically enter medication orders. They can be equipped with tools for decision support (CDS). In Germany, various vendors offer such systems for hospitals and physicians' offices. These systems have mostly been developed during the last five to ten years. Scientific background CPOE-systems exist since the 1970's. Usually, clinical decision support is integrated into the CPOE to avoid errors. Research questions This HTA-report aims to evaluate the effectiveness and efficiency of CPOE-/CDS-systems and their ethical, social and legal aspects. Methods The systematic literature search (27 international data bases) yielded 791 abstracts. Following a two-part selection process, twelve publications were included in the assessment. Results All reviews and studies included in the present report show that the use of CPOE-/CDS-systems can lead to a reduction of medication errors. Minor errors can be eliminated almost completely. The effect of CPOE-/CDS-systems on the rate of adverse drug events (ADE) is evaluated in only two primary studies with conflicting results. It is difficult to compare the results of economical studies because they evaluate different settings, interventions and time frames. In addition, the documentation often is not fully transparent. All four studies included measure costs and effects from the perspective of a hospital or hospital affiliation. Concerning social aspects, the literature points at changes regard competing interests of technology and humans that result from the implementation of CPOE-systems. The experience of institutions in which the implementation of CPOE-systems leads to problems showed that the importance of considering the socio-organisational context had partly been underestimated. Discussion CPOE-/CDS-systems are able to reduce the rate of medication errors when ordering medications. The adherence to guidelines, communication, patient care and personnel satisfaction can also be ...

Computerized physician order entry (CPOE) has been known as a process of physician orders in an electronic way instead of the traditional paper-based system. CPOE has been included as one of core objectives in the term 'Meaningful Use' by Centers for Medicare and Medicaid Services. The U.S. Department of Health and Human Services Office of Inspector General reported 180,000 deaths in the United States in 2008 due to medication errors. The Institute of Medicine reported about 450,000 preventable adverse drug effects which costed additional $3.5 billion. On average, 1.7 medication errors per day and 74.5% errors in parenteral drugs administration were reported in the intensive care unit (ICU). The purpose of this research was to examine the benefits, barriers and risks of CPOE adoption in different ICUs. The methodology for this study was a literature review. Research was conducted by collecting scholarly online database and government websites. On one hand, CPOE could provide patient's health record regardless of time and place, alerts in drug interactions, and suggest in clinical decisions in ICUs. CPOE could also reduce medication errors and adverse drug events significantly. On the other hand, CPOE could provide better solutions if it would be used with real-time conversation and as per workflow of ICUs. In addition, user satisfaction and sufficient training, were important factors in implementing CPOE with more successful and desired outcomes.

Background: Medication errors in chemotherapy are frequent and lead to patient morbidity and mortality, as well as increased rates of re-admission and length of stay, and considerable extra costs. Objective: This study investigated the proposition that computerised chemotherapy ordering reduces the incidence and severity of chemotherapy protocol errors. Method: A computerised physician order entry of chemotherapy order (C-CO) with clinical decision support system was developed in-house, including standardised chemotherapy protocol definitions, automation of pharmacy distribution, clinical checks, labeling and invoicing. A prospective study was then conducted in a C-CO versus paper based chemotherapy order (P-CO) in a 30-bed chemotherapy bay of a tertiary hospital. Both C-CO and P-CO orders, including pharmacoeconomic analysis and the severity of medication errors, were checked and validated by a clinical pharmacist. A group analysis and field trial were also conducted to assess clarity, feasibility and decision making. Results and Conclusion: The C-CO was very usable in terms of its clarity and feasibility. The incidence of medication errors was significantly lower in the C-CO compared with the P-CO (10/3765 [0.26%] versus 134/5514 [2.4%]). There was also a reduction in dispensing time of chemotherapy protocols in the C-CO. The chemotherapy computerisation with clinical decision support system resulted in a significant decrease in the occurrence and severity of medication errors, improvements in chemotherapy dispensing and administration times, and reduction of chemotherapy cost.

Maintenance management consists of an aggregate effort to perform
maintenance by effectively utilizing manpower and material through the
application of standard procedures. It is a complex and multifaceted
task. An ever‐growing number of computerized maintenance management
information systems are available on the market to facilitate this task.
In order to install a computerized maintenance management system, a
company has two options: either to buy or to develop such a system.
Briefly describes the major functions of maintenance management and
suggests an instrument to evaluate comparatively the available
computerized maintenance management systems.

ABSTRACTThis paper discusses results of a longitudinal field experiment to evaluate the implementation of a computer‐based system. This new system includes the introduction of an optically scanned order input form and new computer programs. It is hypothesized that successful implementation would be affected by the quality of service and the personal costs and benefits to the users of the new system. The experimental results show a marked reduction in job satisfaction after implementation of the new system. The implications of the findings for the implementation of computer‐based systems in general are discussed.

A brief review of the Physician Quality Reporting System (PQRS) is presented highlighting the program's legislative history, eligibility requirements and incentive payment plan. Specifically, PQRS measures applicable to neuroradiology practice are discussed. Several steps are suggested for individual physicians or group practices to start participation in the program. Resources are also provided for further information on the program requirements and PQRS measures.

The effect of advertising on the ability of new participants to secure a share of the market, as reflected in earnings; US.

Webbasierte Kommunikationssysteme sorgen für schnellen, möglichst fehlerfreien Austausch von Daten. Die Technik erlaubt es Krankenhauslaboratorien, ihr Angebotsspektrum nicht mehr nur hauseigenen Abteilungen, sondern auch Partnerkrankenhäusern, Niedergelassenen oder Laborgemeinschaften mit anderen Schwerpunkten anzubieten.

In recent years the diagnostic, treatment, educational, and counselling services in the field of rehabilitation in Israel have expanded. As a result, the need arose to centralize information about the services so that it would be possible to provide correct and up‐to‐date information to the professionals, the service planners, the policymakers, and those in need.

Incorrect prescription and administration of medications account for a substantial proportion of medical errors in the USA, causing adverse drug events (ADEs) that result in considerable patient morbidity and enormous costs to the health-care system. Patients with chronic kidney disease or acute kidney injury often have impaired drug clearance as well as polypharmacy, and are therefore at increased risk of experiencing ADEs. Studies have demonstrated that recognition of these conditions is not uniform among treating physicians, and prescribed drug doses are often incorrect. Early interventions that ensure appropriate drug dosing in this group of patients have shown encouraging results. Both computerized physician order entry and clinical decision support systems have been shown to reduce the rate of ADEs. Nevertheless, these systems have been implemented at surprisingly few institutions. Economic stimulus and health-care reform legislation present a rare opportunity to refine these systems and understand how they could be implemented more widely. Failure to explore this technology could mean that the opportunity to reduce the morbidity associated with ADEs is missed.

What started as a prospective study to support clinical leaders and inform strategies to engage their peers in system change was impacted due to a rapidly evolving political agenda amid a pandemic, affecting both organizations and outcomes. Participants in this mixed methods study in one Local Health Integrated Network (LHIN) in Ontario included clinical leaders and community physicians over a period of 14 months. As the provincial government shifted regional healthcare governance from LHINs to Ontario Health Teams, there was an increase in the engagement of community physicians and leaders identified a noticeable culture shift with the potential to drive change. High-performing healthcare systems are dependent not only on physicians who can lead and engage others but a government that can acknowledge this.

Physician ownership of specialty hospitals has become commonplace in recent years in several states where certificate-of-need laws do not exist. The study examines trends in utilization rates for complex and simple spinal fusion procedures performed on injured workers with back/spine disorders in two markets in Oklahoma. During the time period we examine, physician-owned spine or orthopedic specialty hospitals entered both market areas in Oklahoma. Because there were no market areas in Oklahoma without physician-owned spine or orthopedic hospitals to use as a comparison group, we also analyzed trends in utilization for these surgical procedures performed on Medicare beneficiaries. We compared utilization for these procedures in Oklahoma and three other states with a high concentration of physician-owned specialty hospitals (Kansas, South Dakota, and Arizona) to utilization rates for back surgery performed on Medicare patients who reside in the Northeast region. States in the Northeast constitute an appropriate control group because there are no physician-owned specialty hospitals in this region. Both analyses indicate that the entry of the physician-owned specialty hospitals was followed by substantial increases in the market area utilization rates for complex spinal fusion surgery. Conversely, such dramatic changes did not occur in the Northeast where physician-owned specialty hospitals do not exist. After considering but ruling out alternative explanations, the findings imply that the financial incentives linked to ownership coincided with significant changes in physicians' practice patterns.