Although computerized physician order entry (CPOE) with decision support is considered to be integral to patient safety, high implementation costs and unintended consequences have led to mixed reactions. This cost-utility analysis compared CPOE with paper ordering among patients in acute care hospitals and concluded that CPOE would yield cost savings and improve health outcomes by reducing preventable adverse drug events. The authors noted that high implementation costs, which often exceed prior estimates, significantly decreased the projected cost savings. A related editorial suggests these findings argue conclusively for universal CPOE with decision support, despite the short-term challenges of implementation.