Table 1

Priority Table for Further CPOE System Improvements

Failure Mode	CI CPOE	Improvement	CI Improved	↓ CI	Feasibility	Priority
Treatment adaptation forgotten	294	Targeted pop-up alerts (avoid systematic alerts)	105	189	2	X
Contra-indication not considered	294	Link between a patient contra-indication list and drugs contra-indications	126	168	3
Vital signs not considered	245	Integration of vital signs in the electronic patient record	105	140	1	X
Choice of the wrong active substance for the disease	245	Link between the diagnosis and the therapeutic indication of the drug	147	98	3
Antibiotic iv-po switch forgotten	210	Pop-up alerts to propose a switch according to predefine criteria's	90	120	2	X
Wrong patient	196	Improve the readability of the patient name	140	56	1
Retranscription on dispensation documents forgotten	168	Automatic edition of documents needed for the dispensation	42	126	2	X
Drug interaction not considered	147	Keep the same alerts, but showing them before prescription validation	84	63	2
Known allergy not considered	144	Structured alerts during the prescription	72	72	1	X
Retranscription error on dispensation documents	140	Automatic edition of documents needed for the dispensation	28	112	2	X
Drug monitoring or biological follow-up not considered	112	Automatic proposal of important controls related to the prescription	32	80	2
Administration modalities not specified	49	Include reconstitution and administration modalities in the drug database	21	28	2
Monitoring not prescribed	32	New homepage with the monitoring	16	16	1
System unavailability	10	Improve the reliability of WIFI connexion	6	4	2

CI= criticality index, Feasibility: 1= actually under development, 2=medium-term, 3= long-term Priority: X = high priority.

A Risk Analysis Method to Evaluate the Impact of a Computerized Provider Order Entry System on Patient Safety