Implementing A Healthcare Information Infrastructure

The positive effect of CPOE on Emory Healthcare is that, the order entry system is customizable and the CPOE is rapidly improving the system making the physicians to meet their emergency needs. Also, physicians can place their own orders in the system instead relying on the intermediaries like nurses, unit clerks etc. thereby reducing the verbal and communication errors. This system also enables the decision support in which the physicians can directly interact with the ordering provider through CPOE, hence reducing adverse drug events. Apart from this, it reduced hectic long time taking process for pharmacists where traditionally, they were entering medication orders sitting in the pharmacy. After CPOE, it has reduced workload for them, making them to actively participate in ensuring patients safety and making the delivery of hospitalization more

CPOE systems have been proven to decrease medication errors and promote patient safety effectively. A study (Patent Safety Primer, 2014) suggested that 90% of medication errors occurred during the ordering or transcribing stages, and a systematic literature review shows that CPOE was able to reduce those errors by 48% compared to paper-based orders ( Radley, Wasserman & Bradshaw, et al. 2013). CPOE systems are effective in reducing medication errors by eliminating problems related to hand writing,

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.

Charles, K., Cannon, M., Hall, R., & Coustasse, A. (2014, October 1). Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? Perspectives in Health Information Management, 11(Fall): 1b Retrieved from http://perspectives.ahima.org/can-utilizing-a-computerized-provider-order-entry-cpoe-system-prevent-hospital-medical-errors-and-adverse-drug-events/#.Vpg-Q_krLIU

The findings suggested positive impact of CPOE systems in reducing or eliminating disadvantages of manual prescription. Implementation of CPOE systems has improved medication error rates attributed to prescribing (Armada et al., 2014; Helmons et al., 2009; Roberts et

As the technology is being implemented in health care system, computerized provider order entry (CPOE) has become the standard of care in most hospitals. According to Cherry and Jacob (2014), “CPOE contributes to safety and quality by eliminating lost orders automatically, monitoring for duplicate or contradictory orders, and reducing time to fill orders” (p 256). However, there are some barriers using the system which leads to medical errors including alarm However; some barriers are using the system which leads to medical errors including alarm fatigue, lack of communication, and clinicians’ hesitance to adapt to new system. CPOE alert physicians on a constant basis about “various drug-drug, drug-patient, and guideline-based recommendations during the ordering process” causing alert fatigue in clinicians (Payne & Weir, 2015, p 6).

There may be CPOE system design flaws, as well as overwhelming lists of data that are presented that providers have to select from which takes up more time. Eighth, physicians don’t like when they have to do more work on top of the work that they already have to do in a hospital or clinic. There is a change in power structure after CPOE is implemented which means that they may not have the same level of authorization on orders as they used to. CPOE systems have their own set of rules which doctors, nurses, and other healthcare providers have to learn and use to get things done. The ninth problem with CPOE is that it causes a huge reliance on working technology. If system errors occur or outages occur, this can cause major problems for hospitals and private practices if they don’t implement a proper backup plan (Sittig & Ash,

The use and advancement of technology has expanded throughout the years. Technology has recently begun to be incorporated into the healthcare setting to enhance patient care, patient safety, and to optimize therapeutic outcomes. This concept is otherwise known as medical informatics, and is composed of six core areas: electronic health records (EHR), computerized provider order entry (CPOE), electronic prescribing, pharmacy automation and dispensing systems, privacy and security of informatics, and telehealth. Computerized provider order entry specifically refers to a licensed healthcare professional inputting medication orders and other medical information into an electronic pharmaceutical program.1 However, implementing CPOE has revealed

“More than half of the healthcare workers surveyed have witnessed a small percentage of their coworkers break rules, make mistakes, fail to support, demonstrate incompetence, show poor teamwork, disrespect them, and micromanage. Many have seen colleagues cutting corners, making mistakes, and demonstrating incompetence.”(AACN). The HHS or the Department of Health and Human Services, released a document in 2012 under the guidance of Inspector General Daniel R. Levinson, which states that the reporting systems in hospitals to report mistakes are are not used, and were not adequate mainly due to workers confusion on when to use it and how to use it “Hospital staff did not report 86 percent of events to incident reporting systems, partly because of staff misperceptions about what constitutes patient harm. Of the events experienced by Medicare beneficiaries discharged in October 2008, hospital incident reporting systems captured only an estimated 14 percent.” (OIG). The Attorney General’s office gave suggestions to hospitals including but not limited to “create a list of potentially reportable events and provide technical assistance to hospitals in using the list.”(OIG) this would be to simplify the process to give no other option than to report these errors to help their patients receive

The Health Care Industry is complex and is responsible for the health of the country (The Hospital & Healthsystem Association of Pennsylvania; Outcome Engineering, 2010), and ultimately of the world. Unfortunately, according to the Institute of Medicine's comprehensive report, "To Err Is Human," avoidable medical errors annually kill 44,000 - 98,000 hospital patients (Reiling, Knutzen, & Stoecklein, 2003). In addition, as of March 31, 2010, the ten most frequently reported sentinel events within U.S. healthcare organizations are: "wrong site surgery; suicide; operative/post-operative complication; delay in treatment; medical error; patient fall; unintended retention of a foreign body; assault, rape or homicide; perinatal death or loss of function; patient death or injury in restraints" (HealthLeaders Media, 2010). Clearly, many of these

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

Improving patient safety and providing quality care is a top priority in today’s health care forum. Medication errors (MEs) affect many seeking treatment in medical care settings. Computerized provider order entry (CPOE) systems are identified as potential sources for decreasing the occurrence of MEs and adverse drug events (ADEs). Notable health care organizations, including the World Health Organization (WHO), Institute of Medicine (IOM), and the Centers for Medicare and Medicaid Services (CMS), champion CPOE as a solution for improving patient safety and quality of care (Appari, Carian, Johnson, & Anthony, 2012; Cooley, May, Alwan, & Sue 2012; Devine et al., 2010; Khanna & Yen, 2014; Radley et al., 2013; Stone, Smith, Shaft, Nelson, & Money, 2009). Recommendations of CPOE implementation are becoming a motivation for its adoption within the United States (U.S.). While the application of CPOE is growing nationally, there still remains limited utilization. The purpose of this paper is to review the current trends in CPOE adoption, benefits and negative consequences of use, and solutions for CPOE system complications.

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

The last aspect in increasing public awareness involves changing the mindset of the people from individual problem to systems problem. Most people believe that medical errors are the result of the failures of individual providers. The public believes that possible solutions to medical errors are to keep health professionals with bad track records from providing care and give better training to health professionals. The IOM report stated that it is a systems problem. They emphasized that most of the medical errors are systems related and not attributable to individual negligence or misconduct. The key to reducing medical errors is to focus on improving the systems of delivering care and not to blame individuals. Health care professionals are simply human and, like everyone else, they make mistakes. Research has shown that system improvements can reduce the error rates and improve the quality of health care. A 1999 study indicated that including a pharmacist on medical rounds reduced the errors related to medication ordering by

The health care executives should actively coordinate in problem planning and preparation activities, striving to ensure that their exigency operations plan fits within the whole community plans and represents an accountable approach to the risks an organization might undergo. According to Ek, Goolsby and Wengrovius (2011), health and human service programs should be administered with a very high integrity degree and accuracy. However, states have been hampered for several years by the most auditing and quality control requirements that skew programs towards conformity with the process mandates at the expense of meaningful outcomes. In policy consideration, there is a frustration mood to several states through needless duplications of effort in gathering application information, minor but numerous dissimilarities among linked programs and prohibitions against sharing data across program and department lines. Eliminating these barriers would foster access, decrease administrative burdens, and improve program integrity, yet many remain stubbornly in place through unwillingness at the federal levels limit the boundaries between silos, or to examine the costs versus benefits of excessive program oversight.