Health Information Technology for Patient Care - Essay Example

Computerized Physician/Provider Order Entry (CPOE) refers to an application that allows physicians/providers to enter medical orders into a computer system. The computer system may be located within an inpatient or ambulatory setting. Most CPOE systems allow electronic specification of medication orders as well as laboratory, admission, radiology, referral, and procedure orders (Dixon & Zafar, 2009).
The processes involved in CPOE are simple and straightforward – The physician enters his/her orders into the CPOE system. Depending on the type of order, the concerned departments/people are notified. These people execute the order and document it into the system. The benefits of CPOE are as below:
1) Adherence to guidelines: Through clear and concise communication to proper people/departments, CPOE ensures adherence to order sets
2) Enhanced medication safety: CPOE can help significantly reduce the Adverse Drug Effects (ADE) which may otherwise have arisen due to dispensing errors, excessive dosage, wrong therapy, drug iteration, illegibility, and drug allergy.
3) Reduced cost of operations for hospitals: due to lower medication cost, reduced process time, length of stay and daily defined doses
4) Reduced rate of alerts: CPOE helps decrease the alerts given by pharmacists for solving prescription problems.
5) Reduced turnaround time for medication that is the time the physician writes the prescription to the delivery of medication to the ward
Implementing CPOE efficiently involves tackling several key technical and managerial challenges too. These challenges include:
a) Getting the staff to accept and adjust to the change in processes. The challenges here include getting over the physicians resistance especially that from attending/visiting physicians, and adjusting to the changing work flow for example change from clerical staff entering orders to nurse order entry. Further, physicians need to accept and take time out to enter the orders into the system. Next, some people may need to be trained to use the system so that technological barriers can be removed.
b) Top down commitment: For successful implementation it is important that all concerned in the hospital be committed to the success of the system – from CEO to the nurses.
c) Getting the finance to put the project in place. The initial set up cost of a CPOE system may be high. Therefore, the organisation must commit to full cost financing so that they can implement the system fully. A partially implemented CPOE system will not bring about the entire desired benefits.
d) Technology upgrade: CPOE may require technological up-gradation in the hospital. Computer/server systems may need to be updated in order to efficiently run the system.
e) Developing pre-defined order sets for each department
f) Managing expectation and measuring success: In order to reap full benefits of CPOE, the management must take cognizance of expectations from CPOE within the organization. To high expectations may lead to a general thinking that the system is not worthwhile, and too low expectation may mean that the system is not put to full use. Further, the management must ensure that they set and track some Key Performance Indicators (KPI) which show how the CPOE system is helping the organisation. Weak areas identified from the KPI reports may need further training or knowledge of how to put the system to optimum use.
From the nature of these challenges it is clear that implementing CPOE requires proper planning and dedication of resources for administrative support. The best way to go about implementing the CPOE and overcoming the challenges is to have complete commitment from the top management and to implement it in entire hospital processes rather than just some areas. Further, the CPOE must be a system made by iterations with the clinicians and not something imposed on them. Therefore, they need to be taken on-board right from the start. Finally, all the users of CPOE in the hospital must be given proper training on how to efficiently use the system.
References
Briggs, B. (2004, July). The Top 10 CPOE Challenges. Health Data Management Magazine .
Dixon, B., & Zafar, A. (2009). Inpatient Computerized Provider Order Entry (CPOE). Rockville, MD: Agency for Healthcare Research and Quality.
Eslami, S., de Keizer, N. F., & Abu-Hanna, A. (2008). The impact of computerized physician medication order entry in hospitalized patients—A systematic review. international journal of medical informatics. Vol 77 , 365-376.
Wess, M., Embi, P., Besier, J., Lowry, C., Anderson, P., Thelen, G., et al. (2007). Effect of a Computerized Provider Order Entry (CPOE) System on Medication Orders at a Community Hospital and University Hospital. AMIA Annual Symposium (pp. 796-800). AMIA. Read More