Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1455-1456 (doi:10.1542/peds.2006-0161)
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Perceived Increase in Mortality After Process and Policy Changes Implemented With Computerized Physician Order Entry: In Reply

Yong Y. Han, MD
Department of Pediatrics and Communicable Diseases
University of Michigan Medical School
Ann Arbor, MI 48109

Joseph A. Carcillo, MD
Shekhar T. Venkataraman, MD
Robert S.B. Clark, MD
R. Scott Watson, MD, MPH
Hülya Bayir, MD
Richard A. Orr, MD
Departments of Critical Care Medicine and Pediatrics
University of Pittsburgh School of Medicine
Pittsburgh, PA 15213

Trung C. Nguyen, MD
Department of Pediatrics
Baylor College of Medicine
Houston, TX 77030

The first 20% of the full text of this article appears below.

In Reply.—We appreciate the insightful comments of Longhurst et al, Jacobs et al, and Rosenbloom et al in response to our study findings. They all emphasize the critical importance of careful planning and preparation for successful computerized provider order entry (CPOE) implementation. We wholeheartedly agree. However, these authors also assert that our observations probably resulted from inadequate planning or foresight exercised by the CPOE project team at the Children's Hospital of Pittsburgh (CHP). Although we cannot, ourselves, refute this assertion, we note that members of CHP's CPOE project team seemed to have been well aware of the many potential pitfalls that can impede successful CPOE implementation.1 The report by Upperman et al,1 which described in great detail how CPOE was introduced at CHP, suggests that considerable thought and effort went into our institution's adoption of CPOE technology. This endeavor was rewarded, in fact, with a significant reduction in harmful adverse drug events.2 In this regard . . . [Full Text of this Article]


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