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Patient Safety in the Physician's Office: Assessing the Value of Ambulatory CPOE

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Abstract:

Should physicians in California use computerized patient safety systems when treating patients in their medical offices? A report by the Center for Information Technology Leadership indicates that the answer is "yes." While it is well known that computerized provider order entry systems (CPOE) reduce errors and improve efficiency within hospitals, little has been known about the potential long-term benefits of patient safety software designed for ambulatory care, or ACPOE. According to the report:

*Adoption of sophisticated ACPOE systems in California would save more than $3.2 billion and prevent 249,000 adverse drug events (ADEs) annually. *ACPOE would also avert 156,000 office visits and 23,000 hospital admissions. *ACPOE would save the average provider nearly $29,000 and prevent nine ADEs each year. *Physicians bear the bulk of ACPOE implementation costs, approximately $29,000 in the first year for a 25-provider practice, but don't receive a proportionate share of the its annual cost savings.

Study findings suggest that society would clearly benefit from widespread adoption of ACPOE systems. However, in the current payment environment, other health care stakeholders--not providers--realize most of the financial benefits from ACPOE. The systems are expensive to implement and maintain, suggesting the need for public debate on who finances this valuable technology.