Computerized physician order entry (CPOE) systems have been suggested as a strategy to improve patient safety and quality of care.

Longhurst and colleagues sought to determine the effect of a CPOE system on hospital-wide mortality rates at an academic children's hospital. The system the hospital used included clinical decision support as well as documentation of nursing and support services.

Using the records of discharged patients, the study assessed mortality rates among a cohort of 80,063 patients admitted during the 82 months before implementation of the system (historical controls) compared with mortality rates for the 17,432 patients admitted during the 18 months afterward. All patients included in the analysis spent at least one day on a nonobstetric unit of the hospital.

The hospital's observed-to-expected mortality ratio was significantly lower after implementation of the CPOE system. In addition, the authors compared this mortality ratio with those in a database of patients from 41 other pediatric hospitals. Before the system was implemented the ratios were similar-0.89 for the study hospital compared with 0.90 for the database hospitals. After implementation, the study hospital's ratio was significantly lower (0.45) than the database hospitals' (0.72). Similarly, examination of monthly mortality rates at the study hospital showed a decrease from 1.008 deaths per 100 discharges before use of the system to 0.716 afterward.

The authors recommend conducting similar studies in other inpatient groups as well as studies to assess the cost-effectiveness of these systems.