Application Of A Computerized Physician Order Entry

The identified barriers are financial cost, physician and organizational resistance due to low computer literacy skills and disturbance of workflow caused by CPOE systems. The resistance can be overcomed by strategies such as strong leadership, providing trainings, addressing workflow concerns and advocating related policy changes. (Poon, Blumenthal, & Honour et al. 2004). Currently, Canada Health Infoway ( 2016) has promoted CPOE implementation among health care organizations across Canada. For example, North York General Hospital in Toronto has partnered with Canada Health Infoway to develop CPOE systems and share the order sets freely ( Zeidenberg, 2013). With public awareness of the CPOE gradually increasing, now most physicians recognize the positive impact of using CPOE system to improve patient safety , and they are willing to accept the application (Jung, Hoerbst, & Massari, et al. 2013).

This is displayed by the use of information and technology to communicate, manage knowledge, decrease error and support decision making. The majority of the healthcare world is ran by technology. Almost all charting is done on computers, which allows more than one healthcare professional to view the patients chart at one time. This technology also allows the patient to access their records online keeping them informed of test results. For example, this is exemplified by physicians entering their own orders into the computer. This prevents the use of unapproved abbreviations and mishandling of

Computerized Physician Order Entry (CPOE) is a complex technology mandated by Centers for Medicare Services (CMS) in Meaningful Use criteria for adoption by healthcare providers (Self & Coffin, 2016). CPOE is technology for reduction in medication errors through implementation of standardization of processes to support legibility and reduction in the number of people required to participate in the order workflow, thus decreased delays and errors result due to miscommunication (Hoonakker et al., 2013). Although CPOE highlights improvement in quality and safety, healthcare organizations have expressed difficulty in the implementation due to physician resistance (Hoonakker et al, 2013). This resistance not only contributes to patient safety

Health care providers as well as nurses must keep track of all pertinent patient information and failure to do so leads to detrimental effect on the patient's life. CIS clinical information systems are "large, computerized database management systems that support several types of activities that include physician order entry, result retrieval, documentation and decision support". CIS is intended to replace medical records department of a hospital or any other medical institution. Physicians and clinicians can safely and quickly access information, order medication and treatments and implement appropriate care. CIS will hopefully improve productivity, increase quality care and reduce costs across the organization.

Charles, K., Cannon, M., Hall, R., & Coustasse, A. (2014, October 1). Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? Perspectives in Health Information Management, 11(Fall): 1b Retrieved from http://perspectives.ahima.org/can-utilizing-a-computerized-provider-order-entry-cpoe-system-prevent-hospital-medical-errors-and-adverse-drug-events/#.Vpg-Q_krLIU

Electronic health records are helpful to physicians and healthcare providers, because they can be used between different health facilities and agencies. The Electronic Health Record system can be used to improve the effectiveness, quality care, and reduce cost in the future. This record of information contains the history of the patient’s visits to a healthcare facility along with all documentation regarding contact information, patient histories and allergies. The record also contains a list of medications, billing information, and data pertaining to the patient’s visit. The computerized physician order entry (CPOE) allows the physician to electronically enter patient’s orders and view a patient’s lab or x-ray results. It can help detect adverse effects or medical errors and reduce less suffering of the patient if he/she were to receive the wrong medications.

The use and advancement of technology has expanded throughout the years. Technology has recently begun to be incorporated into the healthcare setting to enhance patient care, patient safety, and to optimize therapeutic outcomes. This concept is otherwise known as medical informatics, and is composed of six core areas: electronic health records (EHR), computerized provider order entry (CPOE), electronic prescribing, pharmacy automation and dispensing systems, privacy and security of informatics, and telehealth. Computerized provider order entry specifically refers to a licensed healthcare professional inputting medication orders and other medical information into an electronic pharmaceutical program.1 However, implementing CPOE has revealed

On average, the guides took 27 minutes to complete. As the results indicate, Hospital A has not implemented some of the recommended practices in the following guides: Computerized Provider Order Entry with Decision Support, Patient Identification, and Test Result Reporting. The total number of these practices are 16 which accounts for 10% of the total recommended practices. Also, there is a number of practices that has been implemented partially in some areas in hospital A. These practices fall into the following guides: Computerized Provider Order Entry with Decision Support, Clinician Communication, High Priority Practice, Organizational Responsibilities, and system interfaces which account for 11% of the total recommended practices. The only guides that hospital A is fully complied with are Contingency Planning and System Configuration guides. The total number of practices that have been fully implemented across all guides is 125 which represent 79% of the total recommended practices.

There are many advantages with the implementation of electronic medical records for the patient. One important advantage is the ability for the patient’s medical record to be shared amongst the patients other physicians. Information that can be shared includes recent labs, diagnostic testing, and prescribed medication. Another advantage is patients are provided access to certain medical information in his or her medical record through a patient portal. This allows patients to have a more active role in their health care. One disadvantage for patients is many feel that once electronic medical records are implemented, office visits become less personal due to the medical assistant, nurse, and/or physician is too busy answering questions on a computer or tablet.

There are several challenges involved in successfully implementing the meaningful use of EHRs. Among the most significant barriers are the high expense involved in upgrading current EHRs to meaningful use compliant EHRs, the computer literacy of medical staff, interoperability and the effective exchange of data for coordinating care between different facilities, and patient privacy and security of their medical information. An additional significant hurdle is the computerized physician order entry (CPOE) criteria. A study conducted by the Journal of the American Medicals Informatics Association found that half of the hospitals that failed to achieve meaningful use cited the primary reason as failing to effectively implement

With the use of electronic health information system, an increase in safety has led to improvement in quality and efficiency of care. For example, one of the essential components that meets the federal regulatory requirement is the use of Computerized Provider Order Entry (CPOE). It allows providers to enter patient care orders and medication electronically to eliminate handwritten error. It also integrates clinical decision support which alerts clinicians of potential harm before the orders are processed. Furthermore, with the ease of data access patient can receive quick and efficient care. Interoperability defined as “the ability of various systems and organizations to work together to exchange information” (Jones & Bartlett Learning, 2014, p. 76) is imperative in data exchanging in a meaningful way allowing accurate information to be shared across the entire team and for better coordination of care. From these data, nurses can create a patient-specific care plan and focus on their problem.

Hospitals have begun implementing Computerized Physician Order Entry (CPOE) systems intended to streamline and computerize the process of maintaining patient records and prescribing medications. These systems allow hospital administrators and healthcare professionals to quickly access clinical guidelines, recommendations, patient information, and other factors critical to patient care all at once. It was the intention of the hospital that the implementation and expense of this new system would reduce the number of errors detected.

Clinical Decision Support can be defined as “providing clinicians, patients or individuals with knowledge and person-specific or population information, intelligently filtered or presented at appropriate times, to foster better health processes, better individual patient care, and better population health” (Wright, 2008). Like many different aspects of healthcare, clinical decision support has evolved with the creation of new technology. This evolution of clinical decision support in itself has and will continue to impact each aspect of Triple Aim.

Implementing Computerized Physician Order Entry (CPOE) is not a simple task, as it aims at various things and raises several concerns; this is due to variety of practice settings. For example, outpatient care is different than the inpatient care. The goals of CPOE also give raise too many issues such as cutting cost using CPOE can become an issue with patient safety. Despite of this authors have come up with some considerations that everyone should consider before implementing CPOE. Those are:

Clinical decision-support systems (CDSS) apply best-known medical knowledge to patient data for the purpose of generating case-specific decision-support advice. CDSS forms the cornerstone of health informatics research and practice. It is an embedded concept in almost all major clinical information systems and plays an instrumental role in helping health care achieve its ultimate goal: providing high quality patient care while, at the same time, assuring patient safety and reducing costs. This computer based systems designed to impact clinician decision making about individual patients at the point in time that these decisions are made. If used properly, CDSS have the potential to change the way medicine has been taught and