May 2013

Document Type


Degree Name



Dept. of Biomedical Informatics


Oregon Health & Science University


Concern about safety and, likewise, errors in medicine exploded after the first Institute of Medicine report “To Err is Human: building a safer health system” in 1999. (1) Adoption of electronic health records, computerized provider order entry, and clinical decision support was intended to make medicine safer for the patient. To this end, a plethora of clinical decision support tools have been added into record keeping and ordering systems known as electronic health records or electronic medical records. Hospitals are complex sociotechnical systems. The result of introducing CPOE and CDS depends on the individual jobs to be done, the workers, the tools, the social environment and the work rule environment. (2, 3)Outcomes of these CPOE and CDS tools have rarely been tested end to end. Individual tools for supporting computerized physician order entry have been designed, including visual and text alerts such as pop ups, soft stops, hard stops, and other attention getters. As the engine




School of Medicine



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