Our study did not examine the likelihood that the erroneous orders placed would be intercepted by pharmacists or other staff and hence, not cause harm.
Nearly 80% of the erroneous orders could be entered, with more than half entered with little or no difficulty or warnings.
Overall, 298 (79.5%) of the erroneous orders were able to be entered including 100 (28.0%) being 'easily' placed, another 101 (28.3%) with only minor workarounds and no warnings.
To test each of these error scenarios, we recruited one to two typical users (mostly medical residents or primary care attending physicians) with at least 1-year experience with the CPOE system (range 1 8) and instructed them to enter the erroneous orders.
Ability to enter these erroneous order scenarios was tested on 13 CPOE systems at 16 sites.
These scenarios were then used to test vulnerability of leading CPOE systems, asking typical users to enter these erroneous orders to assess the degree to which these problematic orders could be entered.
We then performed vulnerability testing to examine whether these errors could be replicated in current CPOE systems with the worrisome finding that the majority (overall, 56.3%) of the selected erroneous orders could be readily entered.
Initial reports suggested that an erroneous order, a so-called fat-finger trade, prompted the sudden move, but that has been dismissed as unlikely by Mr. Gensler and other regulators.
The move comes after erroneous orders placed by the firm caused wild swings on the Shanghai stock market on Friday.
