Cost-Effectiveness of a Computerized Provider Order Entry System in Improving Medication Safety Ambulatory Care

Jun 1, 2014, 00:00
10.1016/j.jval.2014.01.009
https://www.valueinhealthjournal.com/article/S1098-3015(14)00017-5/fulltext
Title : Cost-Effectiveness of a Computerized Provider Order Entry System in Improving Medication Safety Ambulatory Care
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(14)00017-5&doi=10.1016/j.jval.2014.01.009
First page : 340
Section Title : Economic Evaluation
Open access? : No
Section Order : 6

Background

Computerized provider order entry (CPOE) is the process of entering physician orders directly into an electronic health record. Although CPOE has been shown to improve medication safety and reduce health care costs, these improvements have been demonstrated largely in the inpatient setting; the cost-effectiveness in the ambulatory setting remains uncertain.

Objective

The objective was to estimate the cost-effectiveness of CPOE in reducing medication errors and adverse drug events (ADEs) in the ambulatory setting.

Methods

We created a decision-analytic model to estimate the cost-effectiveness of CPOE in a midsized (400 providers) multidisciplinary medical group over a 5-year time horizon— 2010 to 2014—the time frame during which health systems are implementing CPOE to meet Meaningful Use criteria. We adopted the medical group’s perspective and utilized their costs, changes in efficiency, and actual number of medication errors and ADEs. One-way and probabilistic sensitivity analyses were conducted. Scenario analyses were explored.

Results

In the base case, CPOE dominated paper prescribing, that is, CPOE cost $18 million less than paper prescribing, and was associated with 1.5 million and 14,500 fewer medication errors and ADEs, respectively, over 5 years. In the scenario that reflected a practice group of five providers, CPOE cost $265,000 less than paper prescribing, was associated with 3875 and 39 fewer medication errors and ADEs, respectively, over 5 years, and was dominant in 80% of the simulations.

Conclusions

Our model suggests that the adoption of CPOE in the ambulatory setting provides excellent value for the investment, and is a cost-effective strategy to improve medication safety over a wide range of practice sizes.

Categories :
  • Cost/Cost of Illness/Resource Use Studies
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Epidemiology & Public Health
  • Prevalence, Incidence & Disease Risk Factors
  • Public Health
  • Safety & Pharmacoepidemiology
Tags :
  • adverse drug events
  • ambulatory care
  • computerized physician order entry system
  • cost-benefit analysis (cost-effectiveness)
  • medication errors
Regions :
  • North America
ViH Article Tags :