Computerized Provider Order Entry in Pediatric Oncology: Design, Implementation, and Outcomes

Purpose: Pediatric oncology is a challenging environment for computerized provider order entry (CPOE). Our goal was to build on the proven safety features of CPOE and facilitate input of expert clinicians. Methods: A standard, commercially available CPOE system was implemented throughout the hospital. The design of the pediatric oncology implementation was a collaborative effort by a multidisciplinary team of clinicians and information technology experts. Results: During 9 months of configuration effort, 30 medical logic modules and 110 order sets were developed to support pediatric oncology. The proportion of chemotherapy orders submitted using specific research protocol or standard-ofcare order sets increased from 57% to 84% as the number of active order sets grew to 200. The number of medicationrelated patient safety events decreased 39% after implementation of CPOE in pediatric oncology. Acceptance of the system is high in all clinical disciplines. Conclusion: Implementation of CPOE required extensive customization but improved patient safety in this highly complex pediatric oncology environment.