Computer physician order entry: benefits, costs, and issues

Article Abstract:

Several analyses have detected substantial quality problems throughout the health care system. Information technology has consistently been identified as an important component of any approach for improvement. Computerized physician order entry (CPOE) is a promising technology that allows physicians to enter orders into a computer instead of handwriting them. Because CPOE fundamentally changes the ordering process, it can substantially decrease the overuse, underuse, and misuse of health care services. Studies have documented that CPOE can decrease costs, shorten length of stay, decrease medical errors, and improve compliance with several types of guidelines. The costs of CPOE are substantial both in terms of technology and organizational process analysis and redesign, system implementation, and user training and support. Computerized physician order entry is a relatively new technology, and there is no consensus on the best approaches to many of the challenges it presents. This technology can yield many significant benefits and is an important platform for future changes to the health care system. Organizational leaders must advocate for CPOE as a critical tool in improving health care quality.

Prevention, Technology application, Prescription writing, Medical informatics, Medication errors

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Improving health care for older persons

Article Abstract:

Health care of the highest quality promotes successful aging. This paper examines the efforts that have been taken to improve the quality of health care, especially hospital care. Most of these efforts have evaluated conventional treatments of specific diseases; they are critical but underfunded and underused, and many practices persist without much evidence of efficacy. Fewer efforts have attempted to improve care for groups of persons in specific settings, such as the hospital. Three complementary approaches to improving comprehensive outcomes for hospitalized older persons -- Geriatric Evaluation and Management, Acute Care for Elders, and the Elder Life Program -- demonstrate what has been learned about improving care for older persons by redesigning microsystems of care. A research agenda for advancing successful aging should include specific actions to improve the quality of health care.

Science & research, Aging, Research

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Quality of medical care for patients older than age 65 years

Article Abstract:

Many elderly people are not receiving treatments that could benefit them, particularly preventive care. In a study of 420 elderly patients enrolled in two large managed care plans, the quality of care received for 22 medical conditions varied substantially depending on the condition. Stroke patients received the best care whereas dying patients received the worst care.

Geriatrics

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