Archives for December 7, 2005

CPOE is an Independent Risk Factor for Death?

A nice entry from Dr. Andy: Uh oh Computerized Physician Order Entry

Computerized physician order entry (CPOE) is looked on as a panacea which will decrease medical error, improve efficiemcy, and improve patient safety. Only it looks like it has some major, unintended consequences, like increasing death according to an article titled “Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System: in this months Pediatrics.

Anyway, the findings were suprising and alarming:

Among 1942 children who were referred and admitted for specialized care during the study period, 75 died, accounting for an overall mortality rate of 3.86%. Univariate analysis revealed that mortality rate significantly increased from 2.80% (39 of 1394) before CPOE implementation to 6.57% (36 of 548) after CPOE implementation. Multivariate analysis revealed that CPOE remained independently associated with increased odds of mortality (odds ratio: 3.28; 95% confidence interval: 1.94–5.55) after adjustment for other mortality covariables.

Put in plain English, kids transported after implementation of CPOED has a more than 3 fold increased risk of death. Ouch.

(Emphasis mine). Ouch, indeed.

My response is in the comments of Dr. Andy’s post.

“Best” Bad Santa Photo

Several years ago, our younger family made a Ritual Trek to a Mall to ‘See Santa’! The older kids were too old for the experience, and were there mainly because they had to go, and they wanted to see the littlest with the Big Guy.

Youngest daughter was then more than a little skittish and risk-averse, so why we thought this would go well is, in retrospect, completely beyond me.

Here’s how it went:

Sanat wants to cry, too

In discussing this with friends and family over the years, kid meltdowns with Santa seem to very frequent. If you’d like to share your Bad Santa Picture, send me a link (or send me the pic and the story).

Be nice to the Santa surrogates, they earn their pay.

Update! Thanks to reader Celsey, here’s a gallery of 42 Bad Santa photos from

December 7th is Pearl Harbor Day

Pearl Harbor Day

Thank a Pearl Harbor vet. They’re getting hard to find.