J Am Med Inform Assoc 14:400-406 doi:10.1197/jamia.M2238
  • The Practice of Informatics
  • Review Paper

Evaluation of Outpatient Computerized Physician Medication Order Entry Systems: A Systematic Review

  1. Saeid Eslami,
  2. Ameen Abu-Hanna,
  3. Nicolette F de Keizer
  1. Affiliations of the authors: Department of Medical Informatics, Academic Medical Center, Universiteit van Amsterdam, Amsterdam, The Netherlands
  1. Correspondence and reprints: Saeid Eslami, Academic Medical Center, Universiteit van Amsterdam, Department of Medical Informatics, J1b-124, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands; e-mail: <s.eslami{at}>
  • Received 2 August 2006
  • Accepted 2 April 2007


This paper provides a systematic literature review of CPOE evaluation studies in the outpatient setting on: safety; cost and efficiency; adherence to guideline; alerts; time; and satisfaction, usage, and usability. Thirty articles with original data (randomized clinical trial, non-randomized clinical trial, or observational study designs) met the inclusion criteria. Only four studies assessed the effect of CPOE on safety. The effect was not significant on the number of adverse drug events. Only one study showed a significant reduction of the number of medication errors. Three studies showed significant reductions in medication costs; five other studies could not support this. Most studies on adherence to guidelines showed a significant positive effect. The relatively small number of evaluation studies published to date do not provide adequate evidence that CPOE systems enhance safety and reduce cost in the outpatient settings. There is however evidence for (a) increasing adherence to guidelines, (b) increasing total prescribing time, and (c) high frequency of ignored alerts.


    Free Sample

    This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of JAMIA.
    View free sample issue >>

    Access policy for JAMIA

    All content published in JAMIA is deposited with PubMed Central by the publisher with a 12 month embargo. Authors/funders may pay an Open Access fee of $2,000 to make the article free on the JAMIA website and PMC immediately on publication.

    All content older than 12 months is freely available on this website.

    AMIA members can log in with their JAMIA user name (email address) and password or via the AMIA website.

    Navigate This Article