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To the Editor: The study by Dr Koppel and colleagues¹ implied that computers can cause medication errors. More accurately, humans cause medication errors. Humans design these computer systems, humans select these computer systems, and humans implement this complex technology in hospitals. A question that should be asked is who in the hospital is making the purchase decisions. It is typically not the physicians and nurses who use the systems. Over the past 3 decades a new integrative discipline of clinical informatics has emerged. Physicians and nurses specifically trained in informatics have a unique blend of education and skills not only in computer science but also in organizational management. This training enables these clinicians to lead process transformation, such as the introduction of online medication orders, and evaluate its effects (both good and bad) on patient care. Clinical informaticians should lead the process of selecting advanced clinical information systems just as . . . [Full Text of this Article]

Charles Safran, MD
Department of Medicine
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, Mass

Don E. Detmer, MD
detmer@amia.org
Department of Health Evaluation Sciences
University of Virginia
Charlottesville

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