CPOE Cultural Impact to Physicians

Cultural Impact to Physicians

The most visible impact of CPOE will be to the physician staff. There is no doubt that the initial implementation of CPOE will increase the amount of time it takes a physician to place orders on a patient.

The increase in time spent will be based on a number of factors. These include:

Physician familiarity with computers in general – Are the individual physicians computer-savvy? Do they surf the Internet? Use email frequently? Use other computer systems available in the hospital?

Application functionality and CPOE build-out – Much depends on the maturity and robustness of the application being used. Order Sets (evidence-based, approved by hospital Medical Executive and Patient Quality/Safety) and Order Groups (common orders) are required to facilitate Physician adoption and improve ordering efficiency.

Application features such as alerts, decision-support, ordering shortcuts such as reflexive orders (additional procedures automatically generated based on initial order selection), future order capability also figure into CPOE adoption. How well the application functions is as important as how well the CPOE application build team defines, develops and tests the system.

Patient complexity – Surgical to Medicine to Critical Care; ICU to Psych to L&D – All patients are created equal: some are ‘more equal’ than others.

This misquote from “Animal Farm” couldn’t be closer to the truth. All patients are equal in terms of the quality of care that they should receive, but it is a fact that some patients are more complicated in terms of care than others.

Translated to physician ordering, it means that, again, all things being equal, some physicians will adapt to CPOE more easily than others simply because of the complexity of their patients and the repetitions the individual physicians will get with the system.

For example, Surgeons performing knee operations will get their repetitions much faster than physicians caring for medicine or critical care patients. Surgical Post-Op orders tend to be less complicated, and surgeons will place more similar orders on more patients faster, because of the nature of their practice. Barring complications, a total knee replacement is a total knee replacement.

CPOE Roles and Responsibilities

Nursing Cultural Change Physician Cultural Change Unit Secretary Cultural Change
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