Impact of Mobile Device Based Software on Prescription Orders: A Quasi-Experimental Study in Iran

Background: One way to reduce medical errors associated with physician orders is Computerized Physician s Order Entry (CPOE) software. The present study aimed to determine mobile device based CPOE impact on reducing prescription orders in a hospital (as the first research in Iran). Methods: We conducted a before-after prospective study in two Intensive Care Unit (ICU) wards (as intervention and control wards) in the largest tertiary public hospital in the south of Iran in 2015 to 2016. All prescription orders were validated by two clinical pharmacist and ICU physician. We compared the rates of ordering errors in medical orders during two phases: one before (manual ordering) and two after implementation of CPOE on mobile devices. A standard checklist was used for data collection. For data analysis, SPSS version 21, descriptive and analytical tests such as McNemar, Chi-square test, and logistic regression were used. Results: We detected 98 prescription errors in 3045 prescribed orders after CPOE implementation on mobile devices (3.0) versus 345 in manual prescription phase (19.1). The use of mobile device based CPOE decreased the prescription errors from 19% to 3% (P = 0.001). There were no any differences in the control ward. More errors occurred in the morning shift (P 0.001) and three types of error, such as illegible orders, lack of writing the drug form and route were significantly reduced in the intervention ward (P 0.05). On the other hand, the CPOE increased three type of errors (P 0.001). Conclusion: The use of mobile device based CPOE significantly reduced the prescription errors. Nonetheless, it is necessary to be more cautious in the use of system. It is recommended that CPOE should be used to improve the quality of delivered services in hospitals.