Computerized Provider Order Entry And Patient Safety

The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.

An error can cost the hospital hundreds of thousands of dollars. Utilizing technology to prevent errors will result in cost savings to the hospital. Implementing CPOE will not only save in prevention of medication errors but also in the decreased time spent in order verification due to illegible handwriting.

Steele, A. M., & DeBrow, M. (2008). Efficiency gains with computerized provider order entry. In: Henriksen K, Battles JB, Keyes MA, Grady ML (eds) Advances in patient safety: new directions and alternative approaches AHRQ publication no 08–0034-4, vol 4. Technology and Medication Safety Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from http://www.ahrq.gov/qual/advances2/

This communication is to inform our fellow team member and most especially the physician groups about the intention of the organization to implement the Computerized Physician Order Entry (CPOE) system. The CPOE application will enable our physician provider to enter order directly into the computer system, the CPOE system will replace the old method of order entry that include, written, verbal order/telephone order, and fax. The CPOE system will enable physician to enter specifications about order such as, laboratory, medication, radiology and special procedure orders. Additionally, CPOE offers some the features of the Clinical Decision Support (CDS) at the point of order entry by recommendation dosage calculations, interactions with other medications, and warning of allergic reaction notifications with alternate medication

The CPOE system failed due to lack of provider by-in. The use of the Medical Informatics Directors Working Group (MIDWG) will help to establish appropriate ownership and control over the process, as well as deliver a design workflow process and order sets that will be accepted and used by the medical staff.

Fourth, there is an issue with “paper persistence” which means that clinicians still turn back to using paper for making annotation, or jotting down quick orders for nurses to take care of. Paper is easily transportable by hand many prefer the old-fashioned method of doing things and writing quick reminders. Some clinicians prefer hand-writing all orders and entering them into the system later on. Fifth, CPOE reduces the amount of face-to-face interaction that occurs between doctors and other healthcare workers. There is the issue with redundant orders that may be verbal or electronically placed due to miscommunication before and

-This case study talks about Emory Clinic implementing a computerized provider order entry system and describes the changes the clinic went through. The case study also talks about how the system affected the hospital and the healthcare works when implementing to system. It discusses people’s reaction to the system and the advantages and problems that arise when the system was being implemented.

Adoption of EHR can derive a great amount of benefits in clinical outcomes such as patient safety and quality of care. Qualtiy of care can be measured with different dimensions such as patient safety, effectiveness, and efficiency. Patient safety is defined as ‘avoiding injuries to patients from the care that is intended to help them’(Menachemi and Collum, 2011, p. 49). Often times, lack of time can contribute to omission of asking patients important questions such as drug allergy information and confirming important patient identifiers such as addresses/phone numbers. Improvement of medication error is a well-noted benefit of EHR as seen in numerous researches. According to a study, researchers found that a CPOE system was contributory in reducing serious medication errors by 55% in the hospital setting (Bates, 1998). Many other studies have reported similar findings in patient safety improvement. When e-prescribing is used, prescriptions can be checked for any drug interactions with

As medication plays an important role when it comes to resolving health related problem and improve patient’s health, at time the process to prescribe or the process followed by many of the clinician itself can be complex and erroneous. Such process can cause many medications related injuries, permanent health related problems. A proper system in place can not only bypass this problem but also helps better manage medication prescribing and lower the cost of medication related operations, Computerized Provider Order Entry is

The Institute of Medicine estimates that preventable medical errors cost the United States nearly $17 billion annually (as cited in McGonigle & Mastrian, 2015). A recommended approach to decreasing these costs is to eliminate handwritten medication and treatment orders and instead use computerized physician order entry (CPOE). CPOE is an electronic prescribing system used for medication and treatment orders written by physicians which eliminates unclear or incomplete orders (McGonigle & Mastrian, 2015). The orders are electronically sent directly to the recipient, reducing errors related to poor handwriting or transcription of medication orders. Furthermore, when the CPOE system is part of electronic health records (EHRs) in conjunction with a clinical decision support system (CDSS) to assist with clinical decision-making tasks, medication orders are checked against all other patient medications to decrease drug interactions or wrong doses (McGonigle & Mastrian, 2015). By utilizing CPOE systems, healthcare providers and patients benefit from safer health outcomes.

As the technology is being implemented in health care system, computerized provider order entry (CPOE) has become the standard of care in most hospitals. According to Cherry and Jacob (2014), “CPOE contributes to safety and quality by eliminating lost orders automatically, monitoring for duplicate or contradictory orders, and reducing time to fill orders” (p 256). However, there are some barriers using the system which leads to medical errors including alarm However; some barriers are using the system which leads to medical errors including alarm fatigue, lack of communication, and clinicians’ hesitance to adapt to new system. CPOE alert physicians on a constant basis about “various drug-drug, drug-patient, and guideline-based recommendations during the ordering process” causing alert fatigue in clinicians (Payne & Weir, 2015, p 6).

The Computerized Provider Order Entry is effective program to help organization improve quality measures and financial margins. The CPOE is effective program; which monitors a hospitals current performance and calculates methods of improvement. For example, Trinity Hospital a leader in clinical intelligence to track and report across it members hospitals on systems wide quality measures (Balgrosky, 2015). The Clinical Provider Order Entry will help patients compare programs graded by the Center for Medicare & Medicaid and Hospital Quality Assurance. This program will further enhance the patient-centric model because patients will have comprehensive comparison of hospitals to make informed medical decision as to where they would like to receive treatment. The quality measures monitor readmission, complications, patient’s experience surveys and other categories. Patients are interested in receiving health care in top-notched care facilities that address their needs. Consumer needs are very important because translating into referrals by word-of-mouth or rankings. Technology plays a major role in an organization's success with supports Judy Murphy idea of enhancing patient’s health information technology

Not only does the electronic method of prescribing save time, it has also cut down on the number of accidents caused by the misinterpretation of handwriting. Although now almost obsolete, hand-written prescriptions have been the cause of many medical errors because certain sound-alike or look-alike drugs have, in the past, been incorrectly substituted for one another. A report given by the insurance company, Excellus BlueCross BlueShield disclosed that if all physicians were to begin using electronic-prescription systems, “more than two million adverse reactions or events – ranging from inconsequential to severe – could be avoided each year” (wgrz.com). According to pharmacist and associate director for the Food and Drug Administration’s Office of Drug Safety, Jerry Phillips, “Six-hundred sound-alike or look-alike drug pairs have been identified as possible sources of error since 1992” (nytimes.com). For example, Lamictal, a mood-stabilizing anticonvulsant, is quite similar in spelling to Lamisil, an antifungal drug. Because of these strong similarities, it is not difficult to understand how easy it could be for medical personnel to mistake certain medications. But with e-prescribing, because the prescription is sent directly from the prescriber to the pharmacy, the number of accidents caused by misinterpretation of handwriting has already been

Medication errors are not only caused by human errors, technology defects contributes to this growing epidemic. Computerized prescribed order entry, bar-coding systems, electronic medication administration and automated dispensing cabinets all contributes to medication errors. However the use of these technologies have included benchmarking to help healthcare facilities test and evaluate new systems for use on the units (Admi, et al., 2013).

Hospitals have begun implementing Computerized Physician Order Entry (CPOE) systems intended to streamline and computerize the process of maintaining patient records and prescribing medications. These systems allow hospital administrators and healthcare professionals to quickly access clinical guidelines, recommendations, patient information, and other factors critical to patient care all at once. It was the intention of the hospital that the implementation and expense of this new system would reduce the number of errors detected.