CPOE

What does CPOE stand for?
computerized provider order entry
What is the purpose of CPOE?
-Automate ordering process to manage patient care more effectively and efficiently and thus improve patient safety and outcomes

-prevent, reduce, or eliminate medical errors and ADEs

-reduce unnecessary variation on health care (standardizes processes) with order sets and optimal ordering decisions and improved adherence to EBM

What is the definition of CPOE?
a variety of different computer-based ordering systems designed to automate the ordering process
-medications
-pathology tests
-radiology tests
-results reporting

*order is documented in a digital, structured, and computable format

What impact can CPOE have?
-Integral to reducing prescribing errors and formulary control
-Improved efficiency of care
-Best couple with a decision support system
-Potential solution to IOM identified problem of up to 98,000 deaths attributed to medical errors
Describe the history of CPOE.
Early development occurred at institutions that developed their own software.

System rights were purchased by companies and commercialized.

What are some of the implementation considerations of CPOE?
-Fundamental redesign of patient care processes
-Integration into the systems workflow and HC delivery
-System-wide change therefore the institution must participate as a whole
-Motivation (internal, external)

-Internal leadership required to sustain support over the extended period of time needed to evaluate, purchase and deploy CPOE
-Costs
-Technical details (authorization of new users, interface development, remote access, customization)

-Training and support
-Continuous improvement

What are the benefits of CPOE?
1. Standardized, complete, legible orders consistent with hospital’s formulary
2. Improved order turnaround
3. Provider ID

4. Linked to ADE reporting systems
5. Reduce over/under prescribing
6. Improved communication among caregivers

7. Reduced cost in delivery of care
8. Improved quality of care

What are major barriers to CPOE?
-CPOE not used
-Large task to implement
-Workflow disruption
-Cost
-E-iatrogenesis (patient harm caused at least in part by the application of HIT)

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