Ashley Bruno- CPOE: Behind the Scenes

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CPOE: Behind the Scenes:

CPOE: Behind the Scenes Presentation created and narrated by Ashley Bruno, RHIA April 27, 2012


What is CPOE? Need for CPOE Benefits of CPOE Disadvantages of CPOE Hospital Implementation Personal findings Agenda

What is C.P.O.E.?:

C omputerized P hysician O rder E ntry What is C.P.O.E.? A computer application that enables clinicians to order and process medications, lab tests, clinical procedures, and other services electronically. -HIMSS, 2011

CPOE Workflow:

CPOE Workflow Clinician inputs order via computer Lab receives order via computer Radiology receives order via computer Pharmacy receives order via computer Nursing receives order via computer Patient care provided System transmits order to appropriate area

Need for CPOE:

Drug therapy problems play a role in high morbidity, mortality, and cost of care ( Allenet et al, 2011, 657) Handwritten orders can be illegible and have a slow response time ( Allenet et al, 2011, 657) Paper order forms cannot offer any type of support or evidence Need for CPOE

Benefits of CPOE:

Reduction in prescribing errors ( Allenet et al, 2011, 657) Drug-drug interaction checking Drug duplication checking Drug-allergy interaction checking Readable orders Better workflow Increased use of order sets ( Banchy & Ross, 2007, 24) Example: Summa Health Systems of Akron, Ohio: 12 percent to 90 percent use of order sets Benefits of CPOE

Disadvantages of CPOE:

Difficulties with physician-nurse collaboration (J.E. van Doormaal et al, 2010,740) New types of medication errors (J.E. van Doormaal et al, 2010,740) Due to new workflow and overriding alerts Alert fatigue Increase in time for certain routines Reliance on technology Important to have a downtime policy & procedure Expensive to implement Disadvantages of CPOE

Hospital Implementation:

Implementation strategy ( Banchy & Ross, 2007, 22) Clear goals, timeline, go-live decisions Physician/nurse involvement ( Banchy & Ross, 2007, 24) Previous perceptions/expectations Honest expectations Performance indicators Used for measuring success Hospital Implementation

Personal Findings:

Physician champions Important for support, setting CPOE up, and training Implementation team on the floor Suggestion: 1 week on the floor Response time Suggestion: beepers Order sets Set up before go-live CPOE meeting Continue after go-live Personal Findings


Allenet , B., Bedouch , P., Bourget, S., Baudrant , M., Foroni , L., Calop , J., & Bosson , J. (2011). Physicians' perception of CPOE implementation. International Journal Of Clinical Pharmacy, 33(4), 656-664. HIMSS. (2011). Meaningful Use Case Study. Retrieved from Kaushal , R., Jha , A., Franz, C., Glaser, J., Shetty , K., Jaggi , T., & ... Bates, D. (2006). Return on investment for a computerized physician order entry system. Journal Of The American Medical Informatics Association, 13(3), 261-266. Ross, C., & Banchy , P. (2007). The key to CPOE: thoughtful planning, flexible training and strong staff involvement leads to a successful CPOE implementation. Health Management Technology, 28 (11), 22. van Doormaal , J. E., Mol , P. M., Zaal , R. J., van den Bemt , P. A., Kosterink , J. W., Vermeulen , K. M., & Haaijer-Ruskamp , F. M. (2010). Computerized physician order entry (CPOE) system: expectations and experiences of users. Journal Of Evaluation In Clinical Practice, 16(4), 738-743. doi:10.1111/j.1365-2753.2009.01187.x References

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