Efficiency of Computerized Physician Order Entry Process in the Outpatient Pharmacy department, Samut Sakhon Hospital

Abstract

Background: In order to provide quality, convenient, fast, and safer patient services, in 2020 Samut Sakhon Hospital adjusted its outpatient medication dispensing system from previously using prescriptions to a new electronic medication dispensing system (computerized physician ordering entry system: CPOE) along with adding a screening point for the accuracy of physician orders by pharmacists before preparing medication. This study investigates the efficiency of the new prescribing system compared to the previous system.

Objective: To study the incidence of medication errors and mean waiting time before and after implementation of the new electronic prescribing system.

Methods: A retrospective study of medication prescribing errors, transcribing errors, dispensing errors, and average waiting time of the new medication ordering system compared to the traditional prescription system, using data from the HOSxP program and the medication error recording program of the outpatient pharmacy I, Samut Sakhon Hospital, during October 2019-January 2020 (traditional drug prescribing system) and during October 2022-January 2023 (new prescription system: CPOE). The data was analyzed statistically.

Result: After implementing the new medication ordering system, medication prescription errors per 1,000 orders increased from 7.62 to 28.49. Conversely, errors in transcribing orders decreased significantly from 23.67 to 0.24 per 1,000 orders, and errors in medication dispensing dropped from 0.04 to 0 per 1,000 orders. The average waiting time for medication increased from 36:03 to 50:36 minutes, which was statistically significantly different (P < 0.001). However, the average time for the entire medication process remained consistent, with 73:01 and 73:02 minutes for the two systems, respectively.

Conclusion: The new medication ordering system using CPOE with screening of medication orders by pharmacists before preparing medication helps increase the ability to capture medication prescribing errors, reduce transcribing errors and dispensing errors, and increase patient medication safety. The average waiting time for medication has increased, but it has no effect on the average time of the patient’s medication receiving process. Therefore, the CPOE should be studied further with other measures to develop the medication ordering system.