CPOE case study Essay

Identify and write the main issues found discussed in the case (who, what, how, where and when (the critical facts in a case).

The applicants are morally correct as long as their action promotes their long term interest. If their action produces or will produce for them a greater outcome of good, versus evil in the long hall than any other alternative, than that action is the right one to act on, and the individual should take that to be a moral act. An Assessment of Morality by Ethicsinbusiness.net

As a member of management Clive Jenkins is responsible for boosting employee morale to ensure that company goals are met

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).

UHN in Toronto is a major community care network that reaches out to and provides care to the masses. However in order to provide this kind of care they must have a very powerful decision support system. UHN utilizes an advanced CPR to support computerized physician order entry (CPOE). (Wu, Perters, & Morgan, 2002) A CPR system is a computer-based patient record system. A CPR system must provide a comprehensive clinical decision support it must include both a patient focus and a population focus. The physical computer system that is installed on the computers at UHN is called Patient 1® which is a clinical information system developed by Atlanta Based Per-Se

The CPOE system failed due to lack of provider by-in. The use of the Medical Informatics Directors Working Group (MIDWG) will help to establish appropriate ownership and control over the process, as well as deliver a design workflow process and order sets that will be accepted and used by the medical staff.

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.

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

Once you have read the case, address these questions. The word limit per response is 150 words.

The Computerized Provider Order Entry is effective program to help organization improve quality measures and financial margins. The CPOE is effective program; which monitors a hospitals current performance and calculates methods of improvement. For example, Trinity Hospital a leader in clinical intelligence to track and report across it members hospitals on systems wide quality measures (Balgrosky, 2015). The Clinical Provider Order Entry will help patients compare programs graded by the Center for Medicare & Medicaid and Hospital Quality Assurance. This program will further enhance the patient-centric model because patients will have comprehensive comparison of hospitals to make informed medical decision as to where they would like to receive treatment. The quality measures monitor readmission, complications, patient’s experience surveys and other categories. Patients are interested in receiving health care in top-notched care facilities that address their needs. Consumer needs are very important because translating into referrals by word-of-mouth or rankings. Technology plays a major role in an organization's success with supports Judy Murphy idea of enhancing patient’s health information technology

Nice post. CPOE is an essential part of EHR and it allows health care professionals to enter orders directly in to a computer and promotes quality of health care and patient outcomes. Pathology services have complex organizational structures with their own rules and conventions. The impact of CPOE on pathology laboratory can vary. Laboratory staff have to adjust to the new practices and processes with the adoption of CPOE. For example with CPOE for an add-on test which occurs when a clinician requires conducting additional test assay is treated as a new test order which can lead to confusion and frustration. This has forced many hospitals to revert back to their previous process requiring doctors to phone and then fax signed handwritten requests

CRITICAL APPRAISAL OF A SYSTEMATIC REVIEW AND NARRATIVE REVIEW RELATED TO COMPUTERISED PHYSICIAN ORDER ENTRY SYSTEM

Hello Consuela, I think you did a good with what you posted. You mentioned, “It will also save time and money without having to use or waste paper or other resources that would be used while manually writing patient care instructions.” I agree with you about it should take less time to submit orders, but the book mentions CPOE may take more of the physician’s time at the front end than with the current manual order processes. Although it has a possibility of taking more time, the physicians should strongly consider using the system because it can help prevent medical errors.

The case study of the Memorial Health Systems CPOE implementation illustrates why the IT implementation process needs to be rigorously applied to complex system definition, implementation and maintenance. The lack of role and responsibility definition, followed by the highly dysfunctional performance of the entire executive team serves as a cautionary tale of why rigorous use of IT implementation processes and frameworks are essential. The implementation failed on many levels, with the factors from Chapter 7 of our text (Wager, Lee & Glaser, 2009) providing a framework for evaluating why the organization in the case failed. In addition, the five dominant causes of project failure as defined in Chapter 14 of our text (Wager, Lee & Glaser, 2009) are also very evident in this case.

2. Describe briefly the history of the litigation of this case (which courts heard the case, which way did they rule, what court is now deciding the case, which judges are hearing the case in this court)?