Computerized Provider Order Entry and Patient Safety

CPOE and CDS are important technologies for improving patient safety that provide functions to prevent and reduce medication errors, but they must be considered in the context of the medication processes into which they are adopted.•CPOE/CDS adoption is a major organizational change involving physicians, nurses, pharmacists, administrators, and information technology professionals. Child safety must be an organizational priority in planning, implementing, and maintaining systems.•CPOE/CDS adoption is complex and requires expertise and detailed knowledge of medication processes and information technology functions, far beyond a simple "build or buy" decision. Pediatric leadership must anticipate the special needs and vulnerabilities of children to medication errors and strive to identify and address them throughout the information technology adoption process and beyond, by advocating timely and periodic system evaluation and awareness of current process and outcome measures.•CPOE/CDS adoption has high initial and ongoing costs of usage and maintenance. ROI analyses show cost and safety benefits over time, but few formal data exist at this time for pediatrics [93]. Adoption of CPOE/CDS (or any health care information technology) is based on "complex, socially negotiated judgments" [94], and it is difficult to identify the factors that determine success or failure [95]. Ongoing research and development work on understanding these factors and addressing the problems of CPOE/CDS adoption [96] into various health care domains (including pediatrics [97]).