The Health Information Management Systems Society

Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are

Electronic health records can lessen the disintegration of care by refining care coordination. The use of electronic health records will deliver providers with accurate information. This is especially important for those that see multiple specialists, and enable a smooth transition between care settings and receive treatment in emergency

Before implementing CPOE at Emory, physicians were able to place orders by writing them on an Order Sheet (or) called a nurse asking him/her to write the orders on an order sheet (Verbal Orders). Once the order sheet was completed, the Unit Clerk held responsible for faxing/scanning the medication orders and sending them to the pharmacy. In addition to this, Unit Clerk was also responsible for entering the orders pertaining to labs and radiology into legacy system and then transmitted them to radiology technicians who would then carry out the ordered lab or imaging procedure.

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

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,

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

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.

Medication Reconciliation is defined by the Joint Commission as the process of checking and rechecking a patient’s current medication list to the patient’s orders. Within a MedRec program, three steps must be followed to ensure patients have the correct medications at admission and discharge: Verification, Clarification, and Reconciliation (Greenwald et al., 2010; Ruggiero et al,. 2015). MedRec should not occur once, but multiple times especially when a patient moves from department to department. The more a patient moves, the more liable they are for a medication error due to poor communication. MedRec is done for the simple reason of catching those medication errors and correcting them before they can do any harm (The Joint Commission, 2006). Medication errors effect nearly 1.5 million people who enter the hospital setting in the USA. At least every patient has one medication discrepancy between admission and discharge, which leads to rehospitalizations due to hospital-setting medication errors (Institute of Medicine as cited by Wilson et al,. 2015). With nurses at the forefront of a patient’s medication regime, pressure is put on them to provide the necessary education and safety to prevent medication related rehospitalizations. Included in the causes for medication errors is miscommunication between departments taking care of the same patient (Allison et al., 2015). Many medication errors are preventable by the implementation of electronic orders. The use of electronic

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

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

By making health information accessible across an entire Acute Care System, Cerner EHR facilitates improved safety, care and coordination by providing clinicians with real-time health information, so that they are able to make more accurately informed decisions. Their electronic health records system eliminates the need for hand-written documentation, provides medical records clarity, improves accuracy and reduces errors. Cerner’s customizable applications were specifically designed to streamline both administrative and clinical tasks. These automated processes, ensures health care professionals are better equipped to maintain and perform all key administrative manipulations of clinical data relevant to each patient of record. Cerner EHR also

Gawande’s (2015) article “Overkill,” suggests that physicians overprescribe drugs and tests which are ultimately unnecessary for patients. To eradicate such behavior, I would implement an electronic health record (EHR) with the following functions: Computerized provider order entry (CPOE) with a clinical decision support system (CDSS) to assist physicians/clinicians (stakeholders) in their medical practice or at hospitals. These functions will help to alleviate redundant tests and make suggestions about treatment. According to HealthIT.gov (2014), CDSS caters chiefly to drugs, laboratory testing, radiology procedures, and helpful clinical literature (HealthIT.gov, 2014).