Benefits of Computerized Physician Order Entry (CPOE) with Case Study; CPOE is the process by which physicians can place patient care orders through an electronic system that informs them about different departments. They usually include pharmacy drug orders, laboratory tests for blood tests, radiological orders, and other patient instructions.

Here are the articles to explain, What are the Benefits of Computerized Physician Order Entry (CPOE) with their Case Study?

CPOE stands therefore often used in electronic prescribing systems that can alert physicians to potential drug-drug or drug-allergy interactions on a specific order. Phase I of the MU program emphasizes the use of CPOE and e-prescriptions, and most physicians implement these two modules – at least – even if they have not yet purchased a complete EHR. CPOE is not just a replacement for paper charts and is a complete overhaul of the complex procurement process. CPOE (computerized physician order entry) has several benefits for physicians and patients:

  • Patient tables were not inaccurate or inaccurate in the administration.
  • Reduce handwriting errors and misunderstandings when placing an order.
  • Improve patient care through clinical decision support systems.
  • Reduce order costs.
  • Comprehensive case documentation and patient history, and.
  • Improve communication between different departments, such as laboratory technicians, doctors, nurses, specialists, etc.

Explanation;

In the above list, perhaps the most striking is saving time and improving efficiency. Clear and legible electronic commands do not require further explanation and there is no room for interpretation. Recipients of the order should not interfere in the course of the prescriber’s work; which further increases the possibility of errors. The time required for ordering, such as receiving results from laboratories or medicines from a pharmacy, stands also significantly reduced.

Although there are many benefits, organizations are slowly adopting CPOE systems due to the high cost of money and technology resources. Procurement systems for large hospitals can cost millions of dollars, and an in-depth analysis of organizational processes require before they can implement. Even if the systems stand already installed, employees need a lot of training and support to learn how to use the new applications.

CPOE systems have a greater impact when integrated with other computing applications within the organization; such as EHR, practice management tools, and electronic prescribing modules. concerns and CPOE implementation. Despite these persistent problems, most healthcare providers are implementing them because of a meaningful service program.

Benefits of Computerized Physician Order Entry (CPOE);

CPOE has existed for decades. But in recent years, and with the growing need to digitize healthcare; CPOE has become more advanced and has increased its use by healthcare providers around the world. The best CPOE (computerized physician order entry) today can provide the following benefits: Three CPOE (computerized physician order entry) benefits;

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  1. Reduce errors.
  2. Increase efficiency and.
  3. Cost savings.
Reduce errors;

The CPOE system saves time and ensures greater accuracy by eliminating manual data entry. This in turn increases patient safety. At least 7,000 people die each year from hospital-related drugs in the United States. Automation reduces fatal human errors. Studies suggest that CPOE has the potential to reduce errors by 13% to 99%; depending on the practical use of the technology and the level of consistency of patient data.

The CPOE automatically records errors when medications exist ordered; because they stand already completed using a computer that matches the order of the patient’s profiles; including laboratory results, general medical history, and insurance information stored in the system to ensure the patient receives the correct prescription.

Increased efficiency;

Another advantage of CPOE stands for increased efficiency. By eliminating manual CPOE data entry, it streamlines the ordering process, an important feature for physicians who have little time. CPOE provides real-time access to inventory levels, pricing information, etc., so you can make informed decisions about your patients’ needs. CPOE allows providers to spend less time on paperwork and more with patients. For orders placed on computers, the CPOE ensures that no orders are lost or ambiguous due to illegible handwriting.

Cost Reduction and savings;

One of the key benefits of CPOE is that it reduces long-term costs for patients and healthcare providers. A large study at the University of Washington, which looked at 400 midsize providers over five years, found that each provider could save hundreds of thousands of dollars by switching from paper prescriptions to CPOE.

The study concluded that adopting a CPOE “is an excellent investment value and a cost-effective strategy to improve drug safety.” For patients, CPOE can help them save time and money in at least two ways. First, it helps patients limit pharmacy visits due to drug orders. Finally, CPOE prevents the patient from receiving the wrong medications, which protects the patient’s health and prevents costly and lengthy hospital stays.

Case Study Making the Problem Worse at Computerized Physician Order Entry (CPOE);

This case study explains what went wrong at Springfield General Hospital and how technology led to more rather than fewer mistakes. This case study will also explore theories of change implementation that would have helped administrators at Springfield General solve the medication mistakes sooner rather than later.

Lastly, how the hospital can solve the problem, and to what extent, if any, would new technology have been helpful. Keywords: change implementation, computerized physician order entry (CPOE), medication errors, adverse drug events, mutual engagement, shared diagnosis

According to Cohn (2015), “most of us think of hospitals as places of healing, and usually, they are. But hospitals are also places where people get sick or stand injured, thanks to medical errors”. During Thanksgiving 2010, an article stood generated about the poor efforts to reduce hospital errors. A study by Grady (2010) found “that harm to patients was common and that the number of incidents did not decrease over time”. Therefore, over the years hospitals have looked for ways to avoid mistakes, however, some have made matters worse.

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What Went Wrong;

Springfield General Hospital stood determined to use technology to correct hospital errors within their organization. The chief administrator decided that technology could help prevent medication mistakes in particular. Spector (2013) stated:

“Prescribing errors, confusion over drugs with similar names, inadequate attention to the synergistic effects of multiple drugs and patient allergies—those and other related errors that are lumped together under the label “adverse drug event” –kill or harm more than 770,00 patients annually in the the the U.S. hospitals”.

Because of this health care costs rose several hundred billion dollars due to adverse drug events. Ironically, the most common type of medication error is poor or illegible handwriting by the physician prescribing the drugs. To rectify these issues, Springfield General sought a computerized physician order entry (CPOE) method to solve medication errors. The Journal of the American Medical Informatics Association Processing (2013) found that “a prescription drug order through a CPOE system decreases the likelihood of error on that order by 48% (95% CI 41% to 55%)”.

More thing;

The hospital stood supposed to adapt to four new standards provided by the CPOE. First off all medications and treatment had to enter into the hospital’s system. Secondly, the entries stood made available to all staff as well as pharmacy staff. Third, due to the design, the system would catch all prescription errors, such as “incorrect dosages, duplicate requisitions, patient allergies, and even adverse effect impact statements of multiple medications being prescribed to a patient”. Fourth, the medical history of all patients would display along with their current clinical guidelines for treatment.

All of these steps assured Springfield General that this system would solve all of their existing medication error problems, instead, they received some disappointing information. In actuality, the CPOE system that Springfield adopted increased adverse drug events and did not eliminate errors. There were multiple dosage errors due to the pharmacy not being aligned with the clinical guidelines. Therefore, some of the dosages that they may have been prescribed were not available in the pharmacy which caused the system to choose the available dosage.

The system design did not take into account medications being discontinued or drugs with similar names. The synergistic effects of multiple drugs and patient allergies were inadequate. The display accessibility was limited when patients had a long history of medications resulting in multiple screens being displayed. Also, the patient records font was displaying small and hard to read at times. As well as, the patient’s name did not appear on every screen that existed associated with them. Therefore, this confused physicians when trying to assign medications and switch between screens.

Theories of Change Implementation;

Mutual engagement and shared diagnosis should have stood considered during the change implementation. Erickson (2016) noted, “that communication and patience are key, and both community and hospital pharmacists need to involve with the CPOE development process to improve medication safety”. From beginning to end the hospital staff and pharmacy need effective communication with one another.

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By partaking in an IT project from the beginning, pharmacy staff would be able to guarantee that their expertise helps guide the process in a way that aligns with their organization’s goals. If departments were sharing their opinions and diagnosis of the system then the view and accessibility issues would have been caught early in the testing stages as well. System administrators could have made the required adjustments.

Solving the Problem;

CPOE systems have unquestionably prevented errors, however, they have inadvertently caused errors as well. The key is to continue developing ways to minimize the errors unintentionally caused by the system. “For example, when designing systems, more care should take to address common problems such as brand versus generic drug names, ineffective searching in terms of filtering drug names and regimens, and confusing screen displays”, Erickson (2016) states. Another area that needs improvement is the flow of accurate and updated information from the hospital to the pharmacy.

Springfield General’s communication with hospital pharmacists needs to improve medication errors. Pharmacists should be providing drug counseling to patients as a safety check to make sure patients are taking the correct drug and dosage. Also, another system may need to perform automatic checks. Kaushal and Bates declared, “CDSSs offer additional functions for the provider to use, such as drug interaction checks, drug allergy checks, and prompts for the provider about when to order a service for a patient”.

To improve entering information for the wrong patients, system administrators could set up a link to verify patients before any data stands entered into their records and when prescribing medication. If the link isn’t feasible staff should force to enter specific information about the patient to access their records. In regards to accessibility, there are many things that the hospital and system admins of the CPOE system could implement to resolve that issue. A side-by-side view may be better than having screens aligned behind one another. Also, the system should allow users to customize the font and sizing according to their preferences.

Conclusion;

CPOE systems have great potential to be an effective solution for hospitals. They eliminate illegible handwriting, integrate electronic medical records, and enable faster data and order transmission to pharmacies as well as other areas in the hospital. Integrating with other systems, such as decision support systems, increases patient safety and improves the quality of patient care. If designed and implemented correctly, CPOE systems could reduce medical errors and ADEs experienced in the US. Organizations that adopt this method have to make sure that they are trained properly, the user interface is not poorly designed, and verification of usability is performed during design, implementation, maintenance, and modification.

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CPOE Computerized Physician Order Entry Benefits Case Study; Image by Stokpic from Pixabay.
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