Once again this year, reducing medical errors and improving patient safety has led the list of information technology priorities for CIO’s, according to the 14th annual HIMSS Leadership Survey. Past reports from the Institute of Medicine (IOM) and The Leapfrog Group detailing the extent of medical errors, plus a steady stream of recent clinical studies that reinforce the persistence of medical errors throughout healthcare delivery (1) have forced the industry to focus on patient safety as the defining characteristic of near term IT strategic planning. But patient safety is about more than just medical error prevention: it is also about correct treatment planning; about clinical excellence; about correct diagnoses; correct processes and procedures; and correct patient therapies. Patient safety is a somewhat ambiguous term, but in its truest form it demands perfect information, perfect processes, and perfect clinical decisions across the spectrum of patient care. That’s just unrealistic, but patient safety can be improved by removing its’ main obstacle – medical errors.

Advocates of e healthcare have championed CPOE as the single most important technology solution to the issue of medical errors as well as a catalyst of healthcare’s digital transformation. Supporters claim that CPOE reduces cost, improves patient safety, minimizes risk and supports clinical efficiency. It’s a growth industry - according to a recent study by Frost and Sullivan, the CPOE market could reach $363.3 million by 2007, up from $224.4 million in 2002. (2) But there’s another side to the CPOE story. Today only about 10% of U.S. hospitals have full CPOE systems, and few use them to their full potential. And according to the 2002 Dorenfest IHDS Survey of 1426 delivery systems, only 30% are in the process of evaluating or implementing CPOE systems. In the same survey less than 25% respondents had most physicians entering orders electronically, 8% had over half of their physicians entering some orders electronically, and 21% of respondents had “some” physicians entering some orders electronically. (3) This represents an unrealized business value of CPOE due to underutilization.