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Professional Intervention: Reminders - computer physician order entry


Patient or encounter specific information, provided on a computer screen aimed at automating the ordering of medication.


Two high quality reviews (Heselmans, Main) and one key review (Kaushal) were identified. In two high quality reviews (Heselmans, Main) this intervention showed mixed effects on improving appropriate care behaviours. The Kaushal review, which examined the effects of CPOE with clinical decision support systems (CDSS) and CDSS alone, had too few studies to make strong conclusions on the intervention's effectiveness on improving prescribing outcomes. There was no evidence located to draw conclusions on the effectiveness of CPOE on other professional behaviours.

Summary of Overall Findings from Reviews

16 reviews that evaluated the effectiveness of computerised order entry systems were identified. Of these, 0/2 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective.

Summary of Findings Related to Prescribing

No high quality or key reviews with a sufficient number of studies to draw conclusions about prescribing outcomes were identified.

Reviews listed as "Summary Pending" will be analyzed, summarized and reported at a later date.

The findings will then be incorporated in the overall evidence summaries of the interventions they address.

Reviews Addressing This Intervention Quality Assessment Tool:
AMSTAR Score (of 11 points)
Main C, Moxham T, Wyatt J, Kay J, Anderson R, Stein K. Computerised decision support systems in order communication for diagnostic, screening or monitoring test ordering: Systematic reviews of the effects and cost-effectiveness of systems. Health Technology Assessment 2010 14 (48):1-227. 9 (High)
Heselmans A, Van de Velde S, Donceel P, Aertgeerts B, Ramaekers D. Effectiveness of electronic guideline-based implementation systems in ambulatory care settings - a systematic review. Implementation Science 2009 4 (82). 8 (High)
Lobach D, Sanders GD, Bright TJ, Wong A, Dhurjati R, Bristow E, Bastian L, Coeytaux R, Samsa G, Hasselblad V, Williams JW, Wing L, Musty M, Kendrick AS. Enabling health care decisionmaking through clinical decision support and knowledge management. Evidence Report/Technology Assessment 2012 (203):1-784. 8
Summary Pending
Durieux P, Trinquart L, Colombet I, Nies J, Walton R, Rajeswaran A, Rege WM, Harvey E, Burnand B. Computerized advice on drug dosage to improve prescribing practice. Cochrane Database of Systematic Reviews 2008 3:CD002894. 7 (Medium)
McKibbon KA, Lokker C, Handler SM, Dolovich LR, Holbrook AM, O'Reilly D, Tamblyn R, Hemens BJ. Basu R. Troyan S. Roshanov PS. Archer NP. Raina P. Enabling medication management through health information technology. Agency for Healthcare Research and Quality Technical Reviews 2011 Evidence R (11-E008-EF). 7 (Medium)
Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The Effect of Electronic Prescribing on Medication Errors and Adverse Drug Events: a Systematic Review. Journal of the American Medical Informatics Association 2008 15 (5):585-600. 6 (Medium)
Duckers M, Faber M, Cruijsberg J, Grol R, Schoonhoven L, Wensing M. Safety and risk management interventions in hospitals: a systematic review of the literature. Medical Care Research and Review 2009 66 (Suppl 6):90S-119S. 6 (Medium)
Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. Archives of Internal Medicine 2003 163 (12):1409-16. 6 (Medium)
Kawamoto K, Lobach D. Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior. AMIA Annual Symposium Proceedings 2003:361-5. 6 (Medium)
Nirantharakumar K, Chen YF, Marshall T, Webber J, Coleman JJ. Clinical decision support systems in the care of inpatients with diabetes in non-critical care setting: systematic review. Diabetic Medicine 2012 29 (6):698-708. 6
Summary Pending
Hodgkinson B, Koch S, Nay R, Nichols K. Strategies to reduce medication errors with reference to older adults. International Journal of Evidence-Based Healthcare 2006 4 (1):15008. 5
Summary Pending
Prgomet M, Georgiou A, Westbrook JI. The impact of mobile handheld technology on hospital physicians' work practices and patient care: a systematic review. Journal of the American Medical Informatics Association 2009 16 (6):792-801. 5 (Medium)
Solomon DH, Hashimoto H, Daltroy L, Liang MH. Techniques to improve physicians' use of diagnostic tests: a new conceptual framework. JAMA 1998 280 (23):2020-7. 5 (Medium)
Weir CR, Staggers N, Phansalkar S. The state of the evidence for computerized provider order entry: A systematic review and analysis of the quality of the literature. International Journal of Medical Informatics 2009 78 (6):365-74. 5 (Medium)
Chan AJ, Chan J, Cafazzo JA, Rossos PG, Tripp T, Shojania K, Khan T, Easty AC. Order sets in health care: a systematic review of their effects. International Journal of Technology Assessment in Health Care 2012 28 (3):235-240. 4
Summary Pending
Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, Morton SC, Shekelle PG. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine 2006 144 (10):742-52. 4 (Medium)
Damiani G, Pinnarelli L, Colosimo SC, Almiento R, Sicuro L, Galasso R, Sommella L, Ricciardi W. The effectiveness of computerized clinical guidelines in the process of care: a systematic review. BMC Health Services Research 2010 10:2. 4
Summary Pending
Fischer S, Tjia J, Field T. Impact of health information technology interventions to improve medication laboratory monitoring for ambulatory patients: a systematic review. Journal of the American Medical Informatics Association 2010 17 (6):631-6. 4 (Medium)
Loganathan M, Singh S, Franklin BD, Bottle A, Majeed A. Interventions to optimise prescribing in care homes: systematic review. Age and Ageing 2011 40 (2):150-162. 4 (Medium)
Meddings J, Rogers M, Macy M, Saint S. Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients. Clinical Infectious Diseases 2010 51 (5):550-60. 4 (Medium)
Moeinedin F, Moineddin R, Jadad AR, Hamid JS, To T, Beyene J. Application of biomedical informatics to chronic pediatric diseases: A systematic review. BMC Medical Informatics and Decision Making 2009 9 (1). 4 (Medium)
Alsulami Z, Conroy S, Choonara I. Medication errors in the Middle East countries: a systematic review of the literature. European Journal of Clinical Pharmacology 2013 69 (4):995-1008. Summary Pending
Georgiou A, Prgomet M, Paoloni R, Creswick N, Hordern A, Walter S, Westbrook J. The effect of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature. Annals of Emergency Medicine 2013 61 (6):644-653. Summary Pending
Lainer M, Mann E, Sonnichsen A. Information technology interventions to improve medication safety in primary care: a systematic review. International Journal for Quality in Health Care 2013 25 (5):590-598. Summary Pending