Nursing/Clinical Database Paper

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.

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.

CPOE systems have been proven to decrease medication errors and promote patient safety effectively. A study (Patent Safety Primer, 2014) suggested that 90% of medication errors occurred during the ordering or transcribing stages, and a systematic literature review shows that CPOE was able to reduce those errors by 48% compared to paper-based orders ( Radley, Wasserman & Bradshaw, et al. 2013). CPOE systems are effective in reducing medication errors by eliminating problems related to hand writing,

CPOE stand for Computerized Provider Order Entry “it is a computerized application designed to assist clinical practitioners in creating and managing medical orders for patients and medication. “(HIMSS Dictionary, 2010. P. 28) CPOE has been in place of written or verbal orders by the providers. CPOE allows provider’s to order diagnostic test, administer medication, draw blood, and do imaging studies from a computer or mobile device. The advantage of CPOE is to help manage patient care more effectively and efficiently. To prevent reduce or eliminate medical records and adverse drug events. As well as improve patient safety, reduce unnecessary variation in health care and improve efficiency of health care delivery. Using CPOE can help prevent

While CPOE is built to reduce the medication errors, it has developed errors causing wrong timing errors on medications. An article called Implementation of a custom alert to prevent medication-timing errors associated with computerized prescriber order entry focused on how to implement custom alert that would reduce the timing conflict for medications (Idemoto et al., 2015). The Arthurs Idemoto et al. explained how Virginia Mason Medical Center worked on how to change their current CPOE to prevent medication timing errors from happening (Idemoto et al., 2015). The Arthurs gave an example of administering an antihypertensive medication. They explained that a doctor orders a medicine to start at 7 a.m. and there was another medication that would

Part of this CDS system would drive key decision making development process for provider as well as real time support, information and diagnosis related pieces. Complex rules once added to CDS, while placing orders through CPOE, system can alert user to check for allergies, overdose of medication and duplication of medication or orders. CPOE along with CDS would not only have these limited benefits but could also help improve hospital’s workflow, rapid and accurate plan of care, quality of care, reduce the cost of care along with being compliant on department of health regulations and guidelines. CPOE has reach not only to inpatient but ancillary environment as well making it more efficient for hospital use. Since both the system CDS and CPOE work alongside it make the process of orders rapid, accurate, decreases order confirmation time to zero and better turnaround time for outcome results.

The findings suggested positive impact of CPOE systems in reducing or eliminating disadvantages of manual prescription. Implementation of CPOE systems has improved medication error rates attributed to prescribing (Armada et al., 2014; Helmons et al., 2009; Roberts et

After decades of paper based medical records, a new type of record keeping has surfaced - the Electronic Health Record (EHR). EHR is an electronic or digital format concept of an individual’s past and present medical history. It is the principle storage place for data and information about the health care services provided to an individual patient. It is maintained by a provider over time and capable of being shared across different healthcare settings by network-connected information systems. Such records may include key administrative and clinical data relevant to that persons care under a particular provider. Examples of such records may include: demographics, physician notes, problems or injuries, medications and allergies, vital

As seen above, prior to CPOE, entering an order is done manually by a physician or a nurse on an order sheet and it is attached to a patient chart. Sometimes, physician used to place verbal orders thereby increasing the scope of communication errors. With the implementation of CPOE, it was overcome and the system came into place where physicians can place orders in the machines or by placing orders remotely across the globe. This has completely reduced relying on the mediators and encouraged physicians to directly place orders even for lab and radiology departments.

Existing healthcare record system is incomplete and inefficient which cannot provide the reliable and efficient healthcare services to patients. So, the proposed EMR System’s Architecture design is produced by keeping following in mind:

“an electronic version of a patients medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports (CMS)”

About 75 million Americans suffer from multiple chronic conditions, which means they require multiple providers for their care. HIEs is the key like these situations for proper diagnosis and there should be adequate communications between the providers. They require communication or exchange of data for coordination of care for this patient. In these instances, health care providers and patients frequently lack pertinent and useful information where treatment decisions are made. In today 's advanced technology, EHRs offer the substantial part to capture and share health information. The vendors, IT developers, and coordinators of health

EHR is an advanced technology for gathering and accessing all clinical data in a dynamic way. This is implemented as major

Digitization has transformed the world order almost in every sector, including health sector. There are numbers of Information and Communication Technology (ICT) based tools and applications in the health sector. Electronic Health Record (EHR), one of such popular ICT based systems, is an electronic record system that acts as a depository of patients’ past and present medical records. Clinical documentation, clinical test and imaging results, computerized order entry system and decision support system are all comprised in EHR (Hayrinen, Saranto & Nykanen, 2008). Thus EHR can construct an errorless data management system for quality, safety and efficient health sector.