Evaluation of outpatient computerized physician medication order entry systems: a systematic review

J Am Med Inform Assoc. 2007 Jul-Aug;14(4):400-6. doi: 10.1197/jamia.M2238. Epub 2007 Apr 25.


This paper provides a systematic literature review of CPOE evaluation studies in the outpatient setting on: safety; cost and efficiency; adherence to guideline; alerts; time; and satisfaction, usage, and usability. Thirty articles with original data (randomized clinical trial, non-randomized clinical trial, or observational study designs) met the inclusion criteria. Only four studies assessed the effect of CPOE on safety. The effect was not significant on the number of adverse drug events. Only one study showed a significant reduction of the number of medication errors. Three studies showed significant reductions in medication costs; five other studies could not support this. Most studies on adherence to guidelines showed a significant positive effect. The relatively small number of evaluation studies published to date do not provide adequate evidence that CPOE systems enhance safety and reduce cost in the outpatient settings. There is however evidence for (a) increasing adherence to guidelines, (b) increasing total prescribing time, and (c) high frequency of ignored alerts.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Decision Support Systems, Clinical*
  • Drug Therapy, Computer-Assisted
  • Evaluation Studies as Topic
  • Guideline Adherence
  • Humans
  • Medical Order Entry Systems* / economics
  • Medication Errors / prevention & control
  • Medication Systems