Emory Healthcare Case

It’s not simply the particular giving of the medications that fare up all the time. It is checking the medical record with the hand written prescriptions, grouping the varied medications and also the instrumentation for giving them, and ensuring all the patients safety measure are covered.

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

The purpose of this paper is to introduce Computerized Provider Order Entry (CPOE) systems in health care practice, and its impact on patient safety through a comprehensive literature review. The background and current implementation of CPOE were reviewed. The benefits and potential disadvantages of CPOE systems related to patient safety were identified, and the strength and gaps in the literature were discussed to suggest further research and guide evidence based health practice.

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

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.

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

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

While CPOE is built to reduce the medication errors, it has developed errors causing wrong timing errors on medications. An article called Implementation of a custom alert to prevent medication-timing errors associated with computerized prescriber order entry focused on how to implement custom alert that would reduce the timing conflict for medications (Idemoto et al., 2015). The Arthurs Idemoto et al. explained how Virginia Mason Medical Center worked on how to change their current CPOE to prevent medication timing errors from happening (Idemoto et al., 2015). The Arthurs gave an example of administering an antihypertensive medication. They explained that a doctor orders a medicine to start at 7 a.m. and there was another medication that would

Hi Donna, I had to chuckle when reading that we can now understand the doctors orders because they are now in the computer. This is very true. Not only are orders much easier to read, but I find we take less verbal orders, so there's less room for error and . Also, doctors have remote access to enter orders and order sets or view their status (such as the result of diagnostic tests) is highly appreciated (Zahra Niazkhani, 2009). The only negative I find is having to wait for the doctors to put in the orders, so they can be followed. An example, the doctor wants a lab, but doesn't put the order in, well I am unable to send the lab because I need a label from the order. So, it can be more time consuming, waiting for them to put in orders. I can

Thank you for your responses. Utilizing two different systems, paper, and electronic order entry is very challenged. It is difficult to teach a nurse orientating to the unit and computer system that they must be very cognizant of order’s entered. I will preface this by saying when a new order is entered it blue until confirmed by a nurse. First, it is very time-consuming for the nurse to click through each other to confirm, therefore, there is an option where the system will automatically take you to the next order to confirm, not confirm or no action. The problem with this is nurses become “click happy” and often confirm orders that are not meant for them to confirm. If an order is specified for Respiratory Therapy—a

Finally, CIS seem to improve healthcare clinicians’ and administrators’ efficiency by providing them with effective tools and speeding the healthcare process in both primary and secondary settings. The use of electronic medical records has resulted positively in the timing of some medical procedures, such as having laboratory test results quickly without affecting patients’ outcome, which allows physicians to review the results and deliver proper care (Kuperman et al., 1999). Furthermore, saving and storing all patients’ data and medical history within EMRs would help clinicians and administrators access data from different settings in real time and avoid documenting repeated data. A study conducted by Donati et al. in a university hospital in Italy indicated that using CIS decreased daily activity time and documentation time by 6 per cent in the Intensive Care Unit compared to the use of paper-based records, which allowed more time to be spent with patients (2008). The use of electronic charts and physician order entry allows ICU staff to access information and tests in real time that is appropriate for ICU requirements. Saarinen et al. did a study in a hospital in Finland and evaluated the change in nursing time in the Intensive Care Unit after implementing CIS in the unit. They found an increase in the time nurses spent caring for patients and accomplishing their daily duties per shift (2005). This

Helpdesk will be provided to end-users. They can ask for support to handle the problem or trouble when they use the system. Go live activities which include analysis the performance of the system and defect detection, will be continuously carried out to ensure the system perfect fit into the business process of company. By using remote support tool, vendor can get the report of system status for monitoring system transaction and any issues occurs will be included as feedback. If any difficulty on using the system is faced on user site, they can get vendor assist based on the service level agreements (SLAs). The SLAs will state out the responsibilities of vendor for clients in term of services and support provided. Feedback from end-users will be gathered for improving the acceptance of end-users for the new system. Training will be given to end-users continuously in order to maximize performance of system during their use. If any issue occurs or faced by end-users, they can search through the support database that embedded in the system for solutions or send a message to vendor for assistance (refer to Figure