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WHY CPOE? |
Date: February 14, 2008 Boston Globe Health News
"One in every 10 patients admitted to six Massachusetts community hospitals suffered serious and avoidable medication mistakes,
according to a report being released today by two nonprofit groups that are
urging all hospitals in the state to install a computerized prescription ordering system."
Where to Start?
CPOE – Computerized Physician/Provider Order Entry – will be one of the most challenging projects a hospital will undertake.
It not only requires a complete analysis and overhaul of the hospital information system infrastructure and base application components, but more importantly, it represents a fundamental shift in hospital culture.
Hospitals have evolved tremendously over the last 20 years from an Information Technology perspective. The line has blurred between Clinical and Informatics. Where does IT’s responsibility begin and end?
CPOE is, at its most basic roots, a Clinical endeavor, yet the Information Technology components outweigh most other factors when designing the actual system.
Another example, on a smaller scale, would be a PACS or GI Documentation application – used by the providers, yet all of the components are computer-based. Telemetry systems are also good examples of blurring lines between clinical and IT – any system that replaces manual processes with automated, by definition, requires input and resources from Information Services.
Some of these systems are so robust, and have been ingrained in hospital culture and process that they are scarcely noticed anymore – except when the lights go out.
Why undertake a CPOE project?
CPOE applications have been around for almost a decade, and documentation is now available that enumerate the benefits, including:
- Potential savings from reduced medical errors
- Direct costs
- Reduced Length Of Stay
- Reduced administrative and clinical departmental staff time used to transcribe, clarify and transmit orders
- Reduced turnaround time for delivery of medications and other clinical services such as laboratory and radiology exams
Overall, the evidence for implementing CPOE systems continues to be noted and documented. Additionally, Local state legislature and insurance providers at present continue to advance the concept of tying reimbursement and hospital licensure to the existence of production CPOE systems.
The result is that CPOE and associated Advanced Clinical Signature systems are here to stay, and will become as much a part of hospital culture as the stethoscope and thermometer.
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