Toward the Elimination of Paper Orders: Managing the Challenge of Low Frequency Physician Users of Computerized Patient Order Entry (CPOE)
| Autor: | Ricardo Ramirez, George A Gellert, S. L. Webster |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Paper
020205 medical informatics As is health care facilities manpower and services education Health Informatics 02 engineering and technology Commit State of the Art / Best Practice Paper Clinical decision support system Medical Order Entry Systems Order entry 03 medical and health sciences Patient safety 0302 clinical medicine Health Information Management Nursing health services administration Physicians 0202 electrical engineering electronic engineering information engineering medicine Electronic Health Records Humans 030212 general & internal medicine Cities Cost implications business.industry medicine.disease Hospitals Computer Science Applications Software modules Medical emergency business Mixed pattern |
| Popis: | SummaryWith the adoption of Computerized Patient Order Entry (CPOE), many physicians – particularly consultants and those who are affiliated with multiple hospital systems – are faced with the challenge of learning to navigate and commit to memory the details of multiple EHRs and CPOE software modules. These physicians may resist CPOE adoption, and their refusal to use CPOE presents a risk to patient safety when paper and electronic orders co-exist, as paper orders generated in an electronic ordering environment can be missed or acted upon after delay, are frequently illegible, and bypass the Clinical Decision Support (CDS) that is part of the evidence-based value of CPOE.We defined a category of CPOE Low Frequency Users (LFUs) – physicians issuing a total of less than 10 orders per month – and found that 50.4% of all physicians issuing orders in 3 urban/suburban hospitals were LFUs and actively issuing orders across all shifts and days of the week. Data are presented for 2013 on the number of LFUs by month, day of week, shift and facility, over 2.3 million orders issued.A menu of 6 options to assist LFUs in the use of CPOE, from which hospital leaders could select, was instituted so that paper orders could be increasingly eliminated. The options, along with their cost implications, are described, as is the initial option selected by hospital leaders. In practice, however, a mixed pattern involving several LFU support options emerged. We review data on how the option mix selected may have impacted CPOE adoption and physician use rates at the facilities. The challenge of engaging LFU physicians in CPOE adoption may be common in moderately sized hospitals, and these options can be deployed by other systems in advancing CPOE pervasiveness of use and the eventual elimination of paper orders. |
| Databáze: | OpenAIRE |
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