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For over a decade, there has been a high prevalence of potentially inappropriate medication (PIM) use as defined by the "Beers criteria" in the outpatient elderly population. Using CPOE medication lists, the measured prevalence of PIMs as of April 1, 2006 was 23.3% (8,693/37,247) of patients at Intermountain Healthcare and 23.0% (5,528/24,004) at the Cleveland Clinic. Patient characteristics associated with PIMs were polypharmacy, female, and multiple primary care visits. A decision support system of geriatric precaution screening alerts for 86 PIMs was integrated into ...