Kaushal Rainu, Jha Ashish K, Franz Calvin, Glaser John, Shetty Kanaka D, Jaggi Tonushree, Middleton Blackford, Kuperman Gilad J, Khorasani Ramin, Tanasijevic Milenko, Bates David W
Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Boston, MA 02120-1613, USA.
J Am Med Inform Assoc. 2006 May-Jun;13(3):261-6. doi: 10.1197/jamia.M1984. Epub 2006 Feb 24.
Although computerized physician order entry (CPOE) may decrease errors and improve quality, hospital adoption has been slow. The high costs and limited data on financial benefits of CPOE systems are a major barrier to adoption. The authors assessed the costs and financial benefits of the CPOE system at Brigham and Women's Hospital over ten years.
Cost and benefit estimates of a hospital CPOE system at Brigham and Women's Hospital (BWH), a 720-adult bed, tertiary care, academic hospital in Boston.
Institutional experts provided data about the costs of the CPOE system. Benefits were determined from published studies of the BWH CPOE system, interviews with hospital experts, and relevant internal documents. Net overall savings to the institution and operating budget savings were determined. All data are presented as value figures represented in 2002 dollars.
Between 1993 and 2002, the BWH spent $11.8 million to develop, implement, and operate CPOE. Over ten years, the system saved BWH $28.5 million for cumulative net savings of $16.7 million and net operating budget savings of $9.5 million given the institutional 80% prospective reimbursement rate. The CPOE system elements that resulted in the greatest cumulative savings were renal dosing guidance, nursing time utilization, specific drug guidance, and adverse drug event prevention. The CPOE system at BWH has resulted in substantial savings, including operating budget savings, to the institution over ten years.
Other hospitals may be able to save money and improve patient safety by investing in CPOE systems.
尽管计算机化医生医嘱录入系统（CPOE）可能会减少差错并提高质量，但医院对其采用的速度一直较慢。CPOE系统的高成本以及关于其经济效益的有限数据是采用该系统的主要障碍。作者评估了布莱根妇女医院CPOE系统在十年间的成本和经济效益。
对布莱根妇女医院（BWH）这一位于波士顿的拥有720张成人病床的三级护理教学医院的医院CPOE系统进行成本和效益估算。
机构专家提供了CPOE系统成本的数据。效益是根据关于BWH CPOE系统的已发表研究、对医院专家的访谈以及相关内部文件确定的。确定了该机构的总体净节省额和运营预算节省额。所有数据均以2002年美元表示的价值数字呈现。
在1993年至2002年期间，BWH花费1180万美元来开发、实施和运营CPOE。在十年间，鉴于该机构80%的预期报销率，该系统为BWH节省了2850万美元，累计净节省额为1670万美元，运营预算净节省额为950万美元。导致最大累计节省的CPOE系统要素是肾脏给药指导、护理时间利用、特定药物指导以及药物不良事件预防。BWH的CPOE系统在十年间为该机构带来了大量节省，包括运营预算节省。
其他医院通过投资CPOE系统可能能够节省资金并提高患者安全。
