Cedars-Sinai Medical Center, the largest private hospital in the West, is suspending use of a multimillion-dollar computerized system for doctors' orders after hundreds of physicians complained that it was endangering patient safety and required too much work.
Ironically, the computer software was designed to do the opposite: Reduce medical errors, allow doctors to track orders electronically, and warn them about dangerous drug interactions and redundant laboratory work.
But, from the start of its rollout in October, the Patient Care Expert program, dubbed PCX, has been plagued with problems, many doctors said.
"The PCX system is presenting too many safety issues in the care of our patients," said cardiologist Dr. Mark Urman. "The only logical, prudent and safe thing to do is to put it on hold until it can be made better."
The uproar is a case study in what can happen as hospitals belatedly modernize record-keeping on a large scale. Years behind other industries, many hospitals are on the cusp of converting from paper to electronic ordering systems to increase efficiency and accuracy.
Interest in computerized physician-order entry software accelerated in 1999 after the influential Institute of Medicine concluded that up to 98,000 patients die annually in hospitals from avoidable medical errors. Large employers, working through a coalition called the Leapfrog Group, began pressuring hospitals to install electronic ordering systems.
A 2000 California law requires hospitals to implement formal plans, including new technologies, to eliminate or substantially reduce medication-related errors by Jan. 1, 2005.
Hospitals and experts are watching Cedars-Sinai because it has developed a customized system they may want to emulate or purchase. Most hospitals buy a commercially available product, but Cedars-Sinai decided to create its own, following the example of other major hospitals such as Brigham and Women's Hospital in Boston and Latter-Day Saints Hospital in Salt Lake City.
Several doctors said they had been told that Cedars-Sinai spent $34 million on the electronic order system, but hospital officials said that estimate was too high. They declined to provide a precise figure.
This week, Cedars-Sinai suspended the ordering system after more than 400 physicians confronted hospital administrators at a tense staff meeting Friday. The doctors voted nearly unanimously to urge the hospital to halt the system until the problems are fixed.
