Computerized Physician Order Entry (EHR)

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

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

You alluded to one of the keys in computerized physician order entry (CPOE) use and provider buy-in in your response – training. In my experience with two EHR implementations in the long term care setting, I observed major issues with the order entry component of the software. I can certainly understand why physicians and nurses are reluctant to use computerized order entry. Further, the order entry systems I have seen are time consuming and difficult to navigate.

By evaluating, comparing and calculating the best fit of three different EHR vendors illustrated in Appendix B, Durity, LLC, will purchase the Epic electronic health record system to replace its ancient paper-based system. The essential categories that an EHR enhances are interoperability, safety/security, quality/reliability, efficiency, and communication. According to Pennic (2014), “Epic continues to dominate the EHR market for hospital and health systems with 37% of users…”. Furthermore, Pennic (2014) reported, “For many physicians, “ease of use” determines their overall perception and experience with the EHR, affecting patient interactions and time spent documenting”.

As an organization that pride itself on continuous improvement it is time to move away from an electronic medical record (EMR) to an electronic health record (EHR). The organization currently utilizes three different EMR, each for different reasons. This has and will continue to make accessing patient information difficult and inefficient as access to each database is dependent on individuals role within the organization. Overall, this will continue to influence patient care negatively. Currently, only nurses have the ability to enter and change orders, therefore, all orders must be given verbally to the nurse or be written down. Further, the system only contains information of each clinics patients and not across the

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

The American Recovery and Reinvestment Act made an investment in the year 2009 to encourage the adoption and implementation of the electronic health records (EHRs)(Cite). EHRs incentive payments were authorized through Medicare and Medicaid to clinicians and hospitals when they privately and securely used EHRs for achieving improvements in care delivery by the Health Information Technology for Economic and Clinical Health Act (HITECH). The healthcare organizations are expected to demonstrate meaningful use of EHRs. This rule of meaningful use has been implemented to strike a balance between acknowledging the urgency of adopting EHRs for improving the healthcare system and identifying the challenges that would be put forth

In efforts to reform the United States healthcare system and create a nationally unified data exchange system the federal government has established an incentive program to eligible professionals and hospitals. The federal government has turned to certified electronic health record (EHR) technology to help facilitate the process of broadening health IT infrastructures. The federal government views EHR system used in meaningful ways as the key to reforming the healthcare systems. Meaningful use of the EHR systems can also improve the overall quality of healthcare, insure patient safety, as well as reduce the cost of healthcare to individuals (Bigalke & Morris, 2010, p. 116).

The American Recovery and Reinvestment Act (ARRA) of 2009 identified three main components of meaningful use: the use of a certified EHR in a meaningful manner, electronic exchange of health information to improve quality of care, and the use of technology to submit clinical outcomes and quality measures (Heath Resources and Service Administration, n.d.). ARRA includes many measures to modernize our nation’s infrastructure, with the “Health Information Technology for Economic and Clinical Health (HITECH) Act” being an example. The HITECH Act is an effort led by Centers for Medicare and Medicare Services (CMS) in support of electronic health records and meaningful use (Centers for Disease Control and Prevention, CDC 2016). According to Galbraith (2013), the HITECH Act aims to promote the use of EHRs by providing over $27 billion in monetary incentives for health care providers that become “meaningful users”. CMS uses these core objectives to determine if a health care provider has satisfied meaningful use and is eligible to receive financial incentives (Galbraith, 2013).

Meaningful use is defined as using certified electronic health record (EHR) technology. It is important to healthcare because of the following; quality, safety and efficiency which reduces health disparities by having computerized physician order entry (CPOE) to document all medical orders that other health care providers inside and outside the hospital to be aware of health management. Maintaining an active medication lists ensuring that any health care provider working with a patient is aware of most or all the medications that a patient is being treated with, and allows the EHR system to make the health care provider aware of any controlled medications, allergies, or drug-drug interactions. Implementation of clinical decision support rules

Meaningful Use is a Centers for Medicare and Medicaid Services (CMS) program that awards incentives to eligible professionals (EP) and hospitals for using electronic health records (EHR) to improve patient care. This paper will provide an overview of the core criteria providers must follow to effectively use the EHR to qualify for the incentives and avoid penalties. The Meaningful Use criteria is implemented in three stages over five years to improve healthcare outcomes. This paper also explores the implementation of meaningful use in health information and how it has directly affected nursing, the nation’s public health, patient outcomes, and population health. Benefits of EMRs are improved patient care and coordination, quality of care and patient safety, improved efficiency and productivity, and financial savings.

Computerized Physician Order-Entry systems or CPOE was introduce to the healthcare field to aid in the reduction of medical errors. The goal of an CPOE system is to reduce healthcare cost by reducing the number of errors, increasing medication safety. With every new product there will always be some unexpected problems that may surface. In regards to CPOE those unexpected problems are referred to as Unintended Adverse Consequences or UAC. According to Sittig & Ash, 2011 UAC’s are events that are neither anticipated or unanticipated, they are simply unfortunate mistakes that happens along the way. Altogether they are nine UAC’s they range from: never ending system demands, more/new work for clinicians, paper persistence, changes in communication patterns and practices, new kinds of error, change in the power structure, workflow issues, emotions, overdependence on technology (Sittig & Ash, 2011). UAC’s can have a huge impact on the implementation as well as the ongoing maintenance of the system. As a result, UAC’s can have a negative outcome when it comes to the patient, cause medical cost to be higher and even unforeseen medical errors. Out of the nine UAC’s this analytical report will focus on the workflow issues.

The Health Information Technology for Economic and Clinical Health Act of 2009 was signed into law with an explicit purpose of incentivizing providers (e.g., physicians and hospitals) to adopt EHR systems. The HITECH Act of 2009 is part of the American Recovery and Reinvestment Act (“stimulus package”). However, given that a bare EHR system provides only partial benefits to patients and society, the HITECH Act requires that providers adopt EHRs and utilize them in a “meaningful” way, which includes using certain EHR functionalities associated with error reduction and cost containment. How do EHRs improve care? What evidence proves that certain EHR “meaningful use” functionalities will translate into benefits? The purpose of this paper is to answer these questions. Impacts include both benefits and drawbacks, and, as such, I will discuss the advantages that have been identified by researchers. Overall, any reader interested in understanding the current state of the knowledge base with regard to EHR benefits will find this paper

Since the implementation of Computerized Provider Order Entry (CPOE), it has brought numerous benefits in terms of patient safety, such as avoiding misinterpretation of ordered medications and treatment due to illegible handwriting of the providers. The CPOE system offered convenience to providers by being able to enter medical orders from any computers anywhere in the hospital or at home. Prior to CPOE, the provider has to physically visit the medical unit or floor where the patient is admitted in order to write an order for the patient. Unfortunately, this convenience has its downside. Some providers skip the face to face interaction with the patient, just reviewed the patient’s medical information from the computer and proceeded to enter

To encourage the adoption and implementation of the electronic health records (EHRs)by healthcare provider’s investment was made in the year 2009 by the American Recovery and Reinvestment Act. For the widespread use of EHRs incentive payments were authorized through Medicare and Medicaid to clinicians and hospitals when they privately and securely use EHRs for achieving improvements in care delivery by the Health Information Technology for Economic and Clinical Health Act (HITECH).The healthcare organizations are expected to demonstrate meaningful use of EHRs. This rule of meaningful use has been implemented to strike a balance between acknowledging the urgency of adopting EHRs for improving the healthcare system and identifying the challenges that would be put forth by this. The federal government would provide resources to support the adoption and implementation of EHRs. It would make $27billion available as incentive payments over a period of 10 years, and as much as $63,750(through Medicaid incentives) and $44,000(through Medicare incentives).