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Doctors are known for bad handwriting and I am not the exception. Yes, my handwriting is very sloppy and it has become worse over the years. We can blame it on the great amount of writing required from physicians during hectic and fast paced working days. Can we take more time and make our notes more legible? Of course we can try, especially if this will reduce errors. However, we would rather spend more time with the patients than with technicalities. Luckily we now count on Computerized Provider Order Entry (CPOE) systems that ensure standardized, legible, and complete orders and consequently potentially reduce both simple and catastrophic errors.
To give you an example, I had a patient admitted for stroke and his condition was stable and manageable; yet his admission almost turned into a tragedy. I handwrote a prescription for 0.5 mg of a sedative and the nurse read and ordered 5 mgs! The patient went into respiratory arrest and we were fortunately able to stabilize him but this could have definitely been prevented. Was this my fault, the pharmacist’s fault or the nurse’s fault? We should not even have to analyze this. This would not have occurred in a computerized system since 5 mgs of this medication would never be an option; therefore, the system would not have allowed it.
Now, why am I writing about CPOE if it seems to be such a positive feature in the health care industry? Well, believe it or not, many physicians and medical institutions are not in favor of CPOE implementation based on no proof of reduced mortality rates. But what about reducing the time to administer a medication? In the traditional paper-based system, the physician writes the prescription, the secretary sends it to the pharmacy, the pharmacy clerk receives it and communicates it to the pharmacist, the pharmacist dispenses the medication and it is then administered to the patient by the nurse. Wouldn’t it be more effective for a doctor to enter a prescription directly in the system to be immediately received by the pharmacist? Besides avoiding many order entry errors preventing high-risk situations this will also guarantee a faster process.
One downside of the CPOE systems is that some physicians are duplicating notes in order to avoid typing and this compromises accuracy. We cannot fall into the leniency that all these technology tools offer nowadays. Let’s embrace this digital era but not forget about the basics in health care. Physicians must always ensure to treat patients as humans, give all patients the same importance and care, and always be compassionate.
