Computerized Provider Order Entry And Patient Safety

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

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/

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.

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).

Computerized provider order entry (CPOE) is a significant piece of stage 1 meaningful use. CPOE in Power Chart allows for disease specific order sets decreasing the amount of free texting entries and therefore decreasing the incident of errors. Power Chart also interfaces with the hospital

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

Organization barrier: due to astronomical cost associated with the implementation of the CPOE system, resistance might stem form top management team. Successfully CPOE implementation required a long term financial commitment, and return of on invested might not be visible in the near future. Additionally, organization barriers are complex, and it will require redesigning the entire workflow process of the entire healthcare organization. Hence, the success of the proposed change might lies with the acknowledgements of these barriers.

Medication errors are not only caused by human errors, technology defects contributes to this growing epidemic. Computerized prescribed order entry, bar-coding systems, electronic medication administration and automated dispensing cabinets all contributes to medication errors. However the use of these technologies have included benchmarking to help healthcare facilities test and evaluate new systems for use on the units (Admi, et al., 2013).

The second barrier with CPOE is the lack of communications among nurse and physicians because physicians can enter orders from anywhere electronically and they don’t have to be at the bedside. As “Communication between physicians and nurses might be changed from a synchronous mode to an asynchronous mode” which “decreases the time spent on patient care” (Ayatollahi, Roozbehi, & Haghani, 2015, p 1-2). Another error that occurs with CPOE is the hesitance to adapt to a new system among health care providers. According to Charles, Cannon, Hall, and Coustasse (2014) that “Physicians are typically set in their ways and hesitant to change” (p 5) because they think that it will decrease patient satisfaction due to less personal contact with their

Fourth, there is an issue with “paper persistence” which means that clinicians still turn back to using paper for making annotation, or jotting down quick orders for nurses to take care of. Paper is easily transportable by hand many prefer the old-fashioned method of doing things and writing quick reminders. Some clinicians prefer hand-writing all orders and entering them into the system later on. Fifth, CPOE reduces the amount of face-to-face interaction that occurs between doctors and other healthcare workers. There is the issue with redundant orders that may be verbal or electronically placed due to miscommunication before and

As medication plays an important role when it comes to resolving health related problem and improve patient’s health, at time the process to prescribe or the process followed by many of the clinician itself can be complex and erroneous. Such process can cause many medications related injuries, permanent health related problems. A proper system in place can not only bypass this problem but also helps better manage medication prescribing and lower the cost of medication related operations, Computerized Provider Order Entry is

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

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