Implementation of a care pathway based computerized order entry system streamlines test ordering and offers tools for benchmarking clinical practice

Autor: Matthias Weemaes, Jeroen Appermont, Joris Welkenhuysen, Ivo Salden, Peter Leemans, Nicole De Wel, Katja Vanoosterwijck, Jef Vanderoost, Herman Arnauts, Leen Antonio, Brigitte Decallonne, Dirk Vanderschueren, Chantal Mathieu, Marc Van Ranst, Florent Vanstapel, Ann Verdonck
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Informatics in Medicine Unlocked, Vol 41, Iss , Pp 101308- (2023)
Druh dokumentu: article
ISSN: 2352-9148
DOI: 10.1016/j.imu.2023.101308
Popis: Background and aims: This is a narrative report on the development of specifications and of the stepwise implementation of a computerized physician order entry system (CPOE) in the University Hospitals Leuven, based on order sets integrated in care pathways. Integration of the CPOE into the electronic health record optimally supports those care pathways. Materials and methods: We investigated adherence to consensus-based use of laboratory tests. We analysed data post- versus pre-implementation test requests for departments selected to cover various patient populations, using the Mann-Whitney U test corrected for the False Discovery Rate. Results: We investigated the effect on the number of tests post- versus pre-implementation. In the emergency and inpatient wards, the CPOE implementation resulted in decreases in requests for uric acid, total protein, direct bilirubin, reticulocyte count, and increases in requests for albumin, glucose and calcium. In the outpatient clinics, where the medical specialties already used non-computerized consensus-based test requesting strategies, effects on the number of requested tests were marginal. In all settings, operational improvements could be inferred: the centrally managed CPOE system resulted in fast and well-controlled management of test strategies, digital traceability of the laboratory test requesting process, automatic archiving of requests, assurance of availability of obligatory information. Conclusions: Overall, test requesting strategies improved towards more consensus-based and operational benefits resulted in time gains and improved efficiency of time spend.
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