CPOE use up 680% in a decade as hospitals get safer than ever

The hospitals of today are nearly unrecognizable when compared to the hospitals of a decade ago. Server racks have replaced filing rooms and clinicians travel the halls with access to the entirety of medical knowledge in their pockets, radically altering the way they deliver necessary care. Computerized provider order entry (CPOE) is another step toward this digital transformation.

While the digitalization of healthcare may have its downsides, one benefit of the revolution is clear: patient safety is at its highest level ever, with hospitals demonstrating consistent improvements in performance over time, according to the benchmark Leapfrog Hospital Safety Grades report.

Leading the positive changes is a mean 680 % increase in the use of CPOE between 2011 and 2022. Mean performance in the spring of 2011 sat at 11.14 percent, while the most recent survey found that 86.98 percent of hospitals now rely on CPOE’s ability to improve the clarity and standardization of orders while offering clinical decision support capabilities to users.

Like all other digital health technologies, CPOE has experienced serious growing pains over this time period. Usability challenges, including confusing options, overwhelming volume of alerts, unnecessary hard stops leading to workarounds, have frustrated users and prompted calls for a major rethink of electronic workflows.

CPOE implementation was a central feature of the Meaningful Use program starting around the same time as the Leapfrog survey, galvanizing its adoption at scale and leading to broader improvements in some of the most challenging areas of usability.

As the technology has matured, it has clearly proven its worth for patient safety. Studies consistently show CPOE is highly effective in preventing medication errors, with researchers finding reductions ranging from 50 percent to more than 80 percent in certain settings.

The widespread adoption of CPOE is linked to a stronger overall focus on patient safety processes during the past ten years, the Leapfrog Group survey finds. Hospitals have made measurable and effective investments in developing a culture of safety, measurement, feedback, and proactive intervention, improving their performance on related cultural safety measures by an average of more than 11 percent.

Their efforts have included increasing staffing levels of ICU physicians and nurses. Hospitals have improved their performance on the ICU physician staffing measure by a mean of 280% since 2011 and have seen a 13.46% improvement in their ability to staff enough qualified nurses to care for patients safely.

Actively encouraging leaders and staff members to take a collaborative approach to preventing errors and harmful events is paying off for patients in numerous ways. Falls and traumas are down by 27 percent, while the number of foreign objects retained during surgery has dropped by a similar amount.

Hospital-acquired infections are also on the decline. MRSA infections are down by a mean of 22.39 percent over the decade, and hospitals have reduced central line-associated bloodstream infections (CLABSI) by 43.75 percent.

“Never in history have we seen across-the-board improvement in patient safety until this last decade, coinciding with the history of the Hospital Safety Grade,” said Leah Binder, president and CEO of The Leapfrog Group. “We salute hospitals for this milestone and encourage them to accelerate their hard work saving patient lives.”

The combination of technology and culture is continuing to make hospital care safer for patients. While there are certainly many more steps to take before CPOE is entirely free of usability concerns and convoluted workflows, the upward trajectory of patient safety performance indicates that the industry is on the right track to improve outcomes and avoid preventable instances of harm to patients receiving inpatient care.

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry. Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.