Computerized Physician Order Entry Paper

Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,

In today’s healthcare industry, technological advances for the treatment of diseases are on the raise and constantly evolving. There is an increase on the usage portable devises capable of record patient’s information, computerized provider order entry (CPOE) stations for prescription drugs order entry use by authorized license health professionals and other systems that can process data and share by other healthcare professionals. With the introduction of an EMR which is a digital version of a paper chart in a doctor’s practice or office. An EMR consist of the medical record history of the patients in one practice, it provides the physician, nurse or clinician the capability of following up patient’s preventive screenings, vaccinations, and records the physician’s notes for future diagnostics and treatment.

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.

CPOE stand for Computerized Provider Order Entry “it is a computerized application designed to assist clinical practitioners in creating and managing medical orders for patients and medication. “(HIMSS Dictionary, 2010. P. 28) CPOE has been in place of written or verbal orders by the providers. CPOE allows provider’s to order diagnostic test, administer medication, draw blood, and do imaging studies from a computer or mobile device. The advantage of CPOE is to help manage patient care more effectively and efficiently. To prevent reduce or eliminate medical records and adverse drug events. As well as improve patient safety, reduce unnecessary variation in health care and improve efficiency of health care delivery. Using CPOE can help prevent

The Leapfrog Group champions use of CPOE to help improve patient safety. CPOE works best when integrated with Clinical Decision Support, which will be reviewed in the next paragraph. When used in conjunction, physicians (or other high-level care providers such as nurse practitioners) can be alerted of potential problems with orders in real time rather than later in the order process. Also, CPOE eliminates errors made due to illegible physician handwriting. Like barriers for EHRs, incorporation of CPOE may result in the need for a complete overhaul in workflow processes, which is often met with much resistance and is extremely time intensive. Training issues are also of note during CPOE implementation. Physicians may be resistant to set aside enough time to train due to fear of lost revenue and backlog of work. Also, physicians may prefer to be trained individually, which can be an expensive, time consuming methods of training. As previously noted, integration of CPOE is touted to improve patient safety by reducing human error, but great care and attention must be paid during the implementation phase. Han et al observed an unintended consequence, an increase in patient mortality, during CPOE implementation at Children’s Hospital of Pittsburg. While CPOE implementation did result in a decrease in adverse drug events, researchers pointed out potential for problems, including increased time to enter orders, delayed medication administration times, reduction in nurse-to-patient ratios, and medications being given at incorrect

Where all the representatives of each committee members and the boards are present and also participating other staff members as needed, I will provide the opportunity to express what made the physicians worry about implementation. I also encourage every individual to express their feeling and the way they think better than the proposed approval, if available. The opposed parties should express why they choose to ignore participating the important staff members like the CIO and IT professionals. I will encourage each group to expect that the meeting is to obtain the right solution for the problem happened. In addition, I commend all parties to have an equal perception of the system implementation rather than two separate ideas. Upon Conesus, we will continue the implementation of the EHR until the completion of the CPOE initiative because rather than waiting for the CPOE initiative, it is better consideration optimizing the performance of both systems. Hence, we will benefit from time management and effective performance of the systems. Either using the same vendor or searching for the new one has no significant effect in the implementation of the system, however, looking for a well-known vendor with various benefits such as vendor with a quality product, up-to-date, cost and the support they provide in implementation should be considered. If

will be able to improve financial outcomes through the application of this system. Additionally, fewer patient errors will mean less legal liability for the organization. The new system should improve efficiency and reduce the time needed to undertake administrative tasks. For healthcare providers, this will mean more time with the patient. In addition, the system should eliminate errors and improve patient outcomes. The

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.

Part of this CDS system would drive key decision making development process for provider as well as real time support, information and diagnosis related pieces. Complex rules once added to CDS, while placing orders through CPOE, system can alert user to check for allergies, overdose of medication and duplication of medication or orders. CPOE along with CDS would not only have these limited benefits but could also help improve hospital’s workflow, rapid and accurate plan of care, quality of care, reduce the cost of care along with being compliant on department of health regulations and guidelines. CPOE has reach not only to inpatient but ancillary environment as well making it more efficient for hospital use. Since both the system CDS and CPOE work alongside it make the process of orders rapid, accurate, decreases order confirmation time to zero and better turnaround time for outcome results.

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.

The study conducted by Leapfrog found that many hospitals are not adopting these systems. The study also found that CPOE is often missing critical errors within the medical record. This is best defined

The Institute of Medicine estimates that preventable medical errors cost the United States nearly $17 billion annually (as cited in McGonigle & Mastrian, 2015). A recommended approach to decreasing these costs is to eliminate handwritten medication and treatment orders and instead use computerized physician order entry (CPOE). CPOE is an electronic prescribing system used for medication and treatment orders written by physicians which eliminates unclear or incomplete orders (McGonigle & Mastrian, 2015). The orders are electronically sent directly to the recipient, reducing errors related to poor handwriting or transcription of medication orders. Furthermore, when the CPOE system is part of electronic health records (EHRs) in conjunction with a clinical decision support system (CDSS) to assist with clinical decision-making tasks, medication orders are checked against all other patient medications to decrease drug interactions or wrong doses (McGonigle & Mastrian, 2015). By utilizing CPOE systems, healthcare providers and patients benefit from safer health outcomes.

-The goals of implementing the CPOE system was to reduce human error. The advantages listed on page 14, listed all the reasons why it should be implemented. In the case study, they stated that there were more positives than negatives about the implementation. Overall the system made operations move at a quicker pace and helped most healthcare workers made less errors in a medical setting.

Because the system is capable of advancing quality of care in numerous ways, the healthcare service providers have been considering to implement the technology in their institutions since the system has been commercially available in the market place since 2006 (Ford, McAlenrney, Phillips, Menachemi, and Rudolph, 2008). Although a good number of institutions have been analyzing the possibility of adopting the system, until recently, it was estimated that only 5% of U.S. hospitals had the system in operation (American Hospital Association Archive). Another study, a 2003 report from First Consulting Group for the American Hospital Association and the Federation of American Hospitals, says that an estimated 5% of American hospitals used CPOE in 2002. Moreover, a report found that the amount of U.S. hospitals with completely available CPOE system was estimated only 9.6% in 2002 [Ash et al, 2004]. Another report from the Leapfrog Group titled “Healthcare Benchmarks and Quality Improvement” has estimated that about 10% of all U.S. hospitals would have completed CPOE implementation by the end of 2006 [Ash et al, 2004]. Add a transition clause here, according to the Leapfrog Group CPOE evaluation tool, it was reported that a mere 8% U.S. hospitals were using the system (Anderson, 2009) 120. Not only the implementation rate but also the usage rate of the system is very slow in recent time. In support of this statement, it was reported that a group of top

Transcription errors such as a misplaced decimal point and illegible handwriting were major causes of error. Incomplete orders were a problem that caused additional steps in the nursing workflow. The implementation of software systems, like CPOE, helps to eradicate these problems. According to Yui et al., (2012), CPOE is a component of the larger electronic health record (EHR) system which enables practitioners to enter orders directly into a computer then transmits orders to the order management system for processing. CPOE is designed to allow clinicians to enter a variety of orders, such as medications, dietary services, consults, admission and discharge orders, nursing orders, lab requisitions, and other diagnostic tests, via computer. The idea behind CPOE was for prescribers, such as physicians, dentists, osteopathic doctors, anesthesiologists, nurse practitioners, and physician assistants, to enter orders directly into the computer. During the ordering process, alerts, such as drug allergy warnings, and other decision support rules should be available to assist health care providers. Once an order is entered, the CPOE system interfaces or integrated with other EHR components, such as a laboratory or pharmacy system, to process the order. In fact, the term “order entry” can be misleading, as CPOE is truly an order management system that allows orders to be