Computerized Physician Order Entry (CPOE)
Kimberly McGlawn
HCIS/255C
8/11/2013
Kristi Berry

Computerized Physician Order Entry
Information technology has consistently been identified as an important component of any approach for improvement. One major improvement in healthcare would be Computerized
Physician Order Entry (CPOE). CPOE is a computer application that physicians use to place orders electronically. This replaces the standard use of hand-written orders on an order sheet or prescription pad. Orders entered into the system are communicated electronically to the departments and personnel responsible for their implementation. The value of computerized physician order entry systems for improving the quality of patient care has become more apparent. CPOE requires a high level of organizational commitment to achieve its potential benefits. Benefits and challenges of CPOE are important topic that clarify its proficient usage and few downfalls. CPOE can substantially decrease the overuse, underuse, and misuse of health care services. Benefits of CPOE are decrease in costs, shorten length of stay, decrease medical errors, and improved medication safety (reducing adverse drug events, or ADEs). A medical error is “An error in the process of ordering, dispensing or administering a medication” (FCG).
An adverse drug event is “an injury resulting from the use of a drug, which may or may not result from an error” (FCG). CPOE can protect the patient and the provider from medical errors by sending alerts when certain tasks are about to be completed. Several different alerts may be provided by the system. An alert may be sent out when a patient is allergic to a particular drug.
This would warn the physician of the allergy and may recommend an alternative medication. An order for a new laboratory test may trigger an alert notifying the physician that the test had recently been ordered and that a result was pending. CPOE can also improve turnaround time by reducing the time from ordering to arrival of the medication.
Some challenges of a CPOE application are cost of implementation, ongoing maintenance, and managerial challenges. The CPOE implementation team must alter physician practices and redesign inpatient are processes involving nurses, pharmacists, physicians and ancillary staff. In some of the early failures of CPOE unwieldy interfaces and time-consuming ordering processes, along with lack of clinical process redesign at the time of implementation.
“Four principle categories of challenges: affording the initial investment and ongoing costs; changing the way physicians work; redesigning inpatient care processes that affect physicians, pharmacist, nurses, and ancillary personnel; and implementing a highly reliable, responsive, and user-friendly CPOE system” (FCG). Many clinics and hospitals are hesitant about switching from paper order entries to computerized order entries because old habits are hard to break. However, there are a considerable amount of healthcare providers that have made the switch and are successful in doing so. Some examples of healthcare providers that use CPOE are licensed nurse practitioners, physician assistants, registered nurses, and other types of doctors such as osteopaths, dentists, and chiropractors. CPOE is still an ongoing process of implementation throughout the healthcare system but will continue to grow and be successful. The bottom line is that CPOE is much more efficient than a burden and will continue to thrive in improving quality of care, patient safety, and clinician efficiency.

References:
First Consulting Group. (2003). Computerized Physician Order Entry: Costs, Benefits and Challenges. Retrieved from http://www.leapfroggroup.org/media/file/Leapfrog-AHA_FAH_CPOE_Report.pdf

Pearson Education, Inc. (2012). Electronic Health Records: Understanding and Using Computerized Medical Records (2nd ed.). Richard Gartee.