Applying Computerized Physician Order Entry ( Cpoe ) Essay

Equally impressive is the implementation of Computerized Physician/provider Order Entry or CPOE. CPOE is known as one of three key patient safety initiatives by Leapfrog Group, a conglomeration of non-health care Fortune 500 company leaders committed to modernizing the current healthcare system (Huston, 2014; The Leapfrog Group, 2013). CPOE is a type of software designed to reduce errors in transcription due to illegible physician handwritings or wrongly placed decimals in dosage and strengths of medications. CPOE also gives the clinician access to Clinical Decision Support, or CDS, which is a database to assist clinicians and providers to health related information for certain patient diagnosis with care planning assistance and direction. (Huston, 2014; The Leapfrog Group, 2013). CPOE and CDS will likely be streamlined and commonly used in healthcare in the next decade which appears will likely improve patient safety as well as vastly reduce medication and

CPOE systems have been proven to decrease medication errors and promote patient safety effectively. A study (Patent Safety Primer, 2014) suggested that 90% of medication errors occurred during the ordering or transcribing stages, and a systematic literature review shows that CPOE was able to reduce those errors by 48% compared to paper-based orders ( Radley, Wasserman & Bradshaw, et al. 2013). CPOE systems are effective in reducing medication errors by eliminating problems related to hand writing,

Steele, A. M., & DeBrow, M. (2008). Efficiency gains with computerized provider order entry. In: Henriksen K, Battles JB, Keyes MA, Grady ML (eds) Advances in patient safety: new directions and alternative approaches AHRQ publication no 08–0034-4, vol 4. Technology and Medication Safety Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from http://www.ahrq.gov/qual/advances2/

An error can cost the hospital hundreds of thousands of dollars. Utilizing technology to prevent errors will result in cost savings to the hospital. Implementing CPOE will not only save in prevention of medication errors but also in the decreased time spent in order verification due to illegible handwriting.

The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.

This affects the delivery of healthcare in that the information needed by providers, physicians, medical staff, and the patients themselves, may not be delivered correctly, timely, and of course securely. Various systems will be discussed and each how they affect healthcare delivery, in particular Electronic Health Record (EHR), Electronic Medical Records (EMR) and Computerized Physician Order Entry (CPOE) (also sometimes referred to as Computerized Provider Order Entry).

Adoption of EHR can derive a great amount of benefits in clinical outcomes such as patient safety and quality of care. Qualtiy of care can be measured with different dimensions such as patient safety, effectiveness, and efficiency. Patient safety is defined as ‘avoiding injuries to patients from the care that is intended to help them’(Menachemi and Collum, 2011, p. 49). Often times, lack of time can contribute to omission of asking patients important questions such as drug allergy information and confirming important patient identifiers such as addresses/phone numbers. Improvement of medication error is a well-noted benefit of EHR as seen in numerous researches. According to a study, researchers found that a CPOE system was contributory in reducing serious medication errors by 55% in the hospital setting (Bates, 1998). Many other studies have reported similar findings in patient safety improvement. When e-prescribing is used, prescriptions can be checked for any drug interactions with

This communication is to inform our fellow team member and most especially the physician groups about the intention of the organization to implement the Computerized Physician Order Entry (CPOE) system. The CPOE application will enable our physician provider to enter order directly into the computer system, the CPOE system will replace the old method of order entry that include, written, verbal order/telephone order, and fax. The CPOE system will enable physician to enter specifications about order such as, laboratory, medication, radiology and special procedure orders. Additionally, CPOE offers some the features of the Clinical Decision Support (CDS) at the point of order entry by recommendation dosage calculations, interactions with other medications, and warning of allergic reaction notifications with alternate medication

Unfortunately providers do not have a choice when it comes to utilizing CPOE since it is a requirement for Stage 1 meaningful use (Step 5, 2015). The benefits of CPOE outweigh providers’ reluctance since CPOE has been shown to be safer than written orders (Step 5, 2015). However, health organizations and IT departments cannot ignore provider reluctance. Training is vital. When I led the implementation of an EMR system at my skilled nursing facility – training superusers was key. We ensured that nurses who were comfortable and knowledgeable with the software worked each shift. The presence of superusers gave the staff an

The findings suggested positive impact of CPOE systems in reducing or eliminating disadvantages of manual prescription. Implementation of CPOE systems has improved medication error rates attributed to prescribing (Armada et al., 2014; Helmons et al., 2009; Roberts et

Over the past decade, virtually every major industry invested heavily in computerization. Relative to a decade ago, today more Americans buy airline tickets and check in to flights online, purchase goods on the Web, and even earn degrees online in such disciplines as nursing,1 law,2 and business,3 among others. Yet, despite these advances in our society, the majority of patients are given handwritten medication prescriptions, and very few patients are able to email their physician4 or even schedule an appointment to see a provider without speaking to a live receptionist. Electronic health record (EHR) systems have the potential to transform the health care system from a mostly paper-based industry to one that utilizes clinical

Physicians use of EHR at Sutter Health created a positive impact especially in communication with regards to a patient’s condition or an order, which used to be a challenge to interpret due to illegible handwriting and unstandardized phrase. Furthermore, Epic has an integrated program for medication ordering which provides suggested dosing, route, and frequency, as well as alerts for possible allergic reaction. Additionally, the use of voice recognition software for progress notes dictation in EHR saved most of the physicians’ time, and the tools available for references on clinical practice guidelines are conveniently linked in the Epic program.

After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when

She continues to state that some templates are designed to capture information from the patient automatically, without the physician actually examining the patient, which not only provides the patient with low quality care but it can also be seen as fraud when documenting services that were not performed but payed or overpaid (Bowman, 2013). Bowman states that clinical decision support systems are another reason to why errors are occurring while using an EHR. According to Bowman, some clinical decision support systems are not programed with the most up to date medical decision knowledge and thus provide inaccurate information. It is important to understand and keep in mind that although clinical decision support systems can be very beneficial in providing assistance with clinical knowledge, it is still a manmade product and can have technical flaws which can lead the provider to have an inaccurate diagnosis and valuable information (Bowman, 2013). Often times, this type of systems can cause the physician to solely depend on the information the system is giving them, thus ignoring their own personal knowledge and education (Bowman, 2013). Lastly, this article also states that other errors arising when using an EHR are those derived from “order entry errors, chart completion errors, chart management errors, and data entry errors” (Phillips, Win, & David,

Not only does the electronic method of prescribing save time, it has also cut down on the number of accidents caused by the misinterpretation of handwriting. Although now almost obsolete, hand-written prescriptions have been the cause of many medical errors because certain sound-alike or look-alike drugs have, in the past, been incorrectly substituted for one another. A report given by the insurance company, Excellus BlueCross BlueShield disclosed that if all physicians were to begin using electronic-prescription systems, “more than two million adverse reactions or events – ranging from inconsequential to severe – could be avoided each year” (wgrz.com). According to pharmacist and associate director for the Food and Drug Administration’s Office of Drug Safety, Jerry Phillips, “Six-hundred sound-alike or look-alike drug pairs have been identified as possible sources of error since 1992” (nytimes.com). For example, Lamictal, a mood-stabilizing anticonvulsant, is quite similar in spelling to Lamisil, an antifungal drug. Because of these strong similarities, it is not difficult to understand how easy it could be for medical personnel to mistake certain medications. But with e-prescribing, because the prescription is sent directly from the prescriber to the pharmacy, the number of accidents caused by misinterpretation of handwriting has already been