Clinical Decision Support System and Computerized Order Entry

The use of technology enables healthcare professionals to provide high-quality care. Various information systems also help healthcare facilities to reduce costs. For instance, computerized order entry (CPOE) and clinical decision support systems (CDSS) have been widely used in clinical settings and highly valued by healthcare professionals and patients (Charles, Cannon, Coustasse, & Hall, 2014). , Wong et al. (2017) claim that the efficiency of these systems in intensive care units is not always beneficial. The researchers note that the use of CPOE and CDSS can be associated with adverse effects in patients especially if patients have allergies. This health issue is often related to various issues involving medication prescription. For instance, cefazolin is an effective drug prescribed to treat infections. However, this medication can cause various allergic reactions (Ramsey, Staicu, & Liu, 2016). This paper includes a brief discussion of possible negative effects associated with the use of cefazolin as well as a description of a strategy aimed to address these issues in the clinical setting.

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As has been mentioned above, allergic reactions are quite common in patients and may cause serious health issues. For instance, patients allergic to penicillin can have various reactions after the use of cefazolin (Ramsey et al., 2016). These reactions vary from simple itching, gastrointestinal events, or rash to shortness of breath or even quite serious kidney injuries. At the same time, this medication has proved to be effective in treating numerous infections that are often associated with surgical interventions. Therefore, this drug is prescribed in many cases, which makes it vital to make sure that patients with allergies will not receive this medication.

The use of CPOE and CDSS can help address this problem. Spaulding and Raghu (2013) stress that the use of these approaches reduces healthcare facilities’ costs and the rate of medical errors. Okumura, Veroneze, Burgardt, and Fragoso (2016) describe an intervention aimed at improving the use of cefazolin in surgical prophylaxis. The system helps healthcare professionals make decisions as to the use of the medication. Thus, when prescribing cefazolin, a healthcare practitioner should go through some points. These steps include the verification of the use of medication prescription in surgical prophylaxis, dosage, and time. If one of the stages is not verified, the prescription is blocked. In simple terms, the system helps healthcare professionals take into account the major aspects to avoid possible medical errors.

However, this approach can be improved by adding one or more steps. Healthcare professionals should ensure that patients are not allergic to the drug. Thus, after the steps mentioned above healthcare professionals should verify the absence of allergies to the drug or associated components. In many cases, data concerning allergic reactions to cefazolin can be absent. In this case, healthcare professionals do not verify the allergies but go to another step, which involves testing. After an appropriate test is implemented, healthcare professionals can insert the corresponding data and verify the use of the drug. It is noteworthy that the new system should be consistent with the EHR used at the healthcare facility, which will make many processes automatized. The system will ensure the necessary attention to this aspect, and adverse effects associated with allergies can be avoided.

As far as the implementation of the new system is concerned, the system will be developed in collaboration with IT specialists (Okumura et al., 2016). Meanwhile, a number of discussions will be held to ensure the acceptance of the new prescription method. The involved healthcare professionals should understand the value of the system as well as the effects and costs of medical errors related to patients’ allergies. It is essential to start with a trial to detect and remove all possible flaws in the system. After the completion of the trial, the involved healthcare professionals will receive training to ensure that all peculiarities of the new prescription methods are clear. It will also be important to receive feedback. Those using the system should report any inconveniences as well as positive effects associated with the use of the new approach. Finally, it can be effective to assess the rate of medical errors associated with allergies before and several months after the start of the project. It is also possible to evaluate the level of healthcare professionals’ satisfaction or dissatisfaction with the new system.

As for possible pitfalls and challenges that may occur, it is necessary to take into account the following issues. One of the most common issues is associated with system errors and faults. These problems can be addressed with the help of continuous monitoring. IT specialist should ensure the proper functioning of the system while healthcare professionals should report any deviations from the functions described above (Okumura et al., 2016). If major errors occur, healthcare professionals will use the system that was employed previously. The loss of data is an issue closely related to the one mentioned above. The way to address this issue is also similar. IT specialists will address the system’s flaws, healthcare professionals will use available systems or even print documents.

Another possible challenge can be associated with healthcare professionals’ dissatisfaction and reluctance to use the new method. The staff can think of a system as something redundant and useless. This dissatisfaction can translate to inefficient work of the system as medical staff can try to avoid using it and complain about its malfunctions. Discussions involving healthcare professionals can help address the issue. It is essential to draw people’s attention to the costs related to medical errors in general and incorrect prescriptions in particular. It is also vital to discuss all peculiarities of the system with people who will use it. Employees should understand the benefits of using the new prescription method.

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In conclusion, it is possible to note that the use of CPOE and CDSS, as well as other information technologies, can help healthcare professionals avoid various medical errors. One of the possible benefits of the use of these systems is the correct prescriptions of cefazolin. One of the health issues that still need close attention is an allergy. Allergic reactions can cause a lot of inconvenience for patients or even negative health outcomes. Therefore, medical staff should take into account this aspect when prescribing this drug. The system described above can help healthcare professionals pay the necessary attention to this area. At that, the new approach should also be implemented properly. The implementation should involve close collaboration with IT specialists as well as the medical staff. Discussions and training will be necessary. It can be beneficial to evaluate the effectiveness of the new approach. Finally, it is essential to take into account some challenges that can occur. The challenges include system errors and healthcare practitioners’ reluctance. These obstacles can also be addressed with the help of collaboration with the IT department and extensive discussion of some benefits of the new approach with the medical staff.


Charles, K., Cannon, M., Coustasse, A., & Hall, R.S. (2014). Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? Perspectives in health information management, 11, 1-17.

Okumura, L., Veroneze, I., Burgardt, C., & Fragoso, M. (2016). Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: A cost saving analysis. Pharmacy Practice, 14(3), 717-725.

Ramsey, A., Staicu, M., & Liu, L. (2016). Perioperative use of cefazolin in patients with reported penicillin allergy. Journal of Allergy and Clinical Immunology, 137(2), AB42.

Spaulding, T., & Raghu, T. (2013). Impact of CPOE usage on medication management process costs and quality outcomes. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 50(3), 229-247.

Wong, A., Amato, M., Seger, D., Slight, S., Beeler, P., & Dykes, P., … Bates, D. (2017). Evaluation of medication-related clinical decision support alert overrides in the intensive care unit. Journal of Critical Care, 39, 156-161.

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