Difference between revisions of "Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE"

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(Second Review)
(Second Review)
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= Second Review =
 
= Second Review =
This is a review of an article by Ohsfeldt et al, ''Implementation of Hospital Computerized Physician Order Entry Systems in a Rural State: Feasibility and Financial Impact
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This is a review of an article by Shriner et al, ''Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE'' <ref name="Shriner-2014> Shriner, A. R., & Webber, E. C. (2014). Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE. Appl Clin Inform, 5(3), 721-730.</ref>
'' <ref name="Ohsfeldt-2005> Ohsfeldt, R. L., Ward, M. M., Schneider, J. E., Jaana, M., Miller, T. R., Lei, Y., & Wakefield, D. S. (2005). Implementation of hospital computerized physician order entry systems in a rural state: feasibility and financial impact. Journal of the American Medical Informatics Association, 12(1), 20-27. </ref>
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== Objective ==
 
== Objective ==
To estimate the cost of implementing computerized physician order entry [[CPOE]] systems in hospitals from a rural state and to evaluate the financial implications of statewide CPOE implementation.
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To investigate the attitudes and perceptions of residents before and after the implementation of [[CPOE | CPOE]] and [[CDS|CDS]] system.
 
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== Methods ==
 
== Methods ==
CPOE cost estimates were obtained from a CPOE vendor. A survey was used to obtain current clinical information system. Published patient care revenue and operating cost from Iowa Hospital Association were used to simulate the financial impact of COPE implementation.  
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Web-based survey was used to collect data from pediatric residents prior to CPOE implementation and at 6 months as well as at 12 months post implementation. The survey included a variety of multiple choice questions, free text response and Likert scale queries. Descriptive statistics was used to compare pre and post implementation results.
  
 
== Results ==
 
== Results ==
CPOE implementation dramatically increases operating costs for rural and critical access hospitals. For urban and rural referral hospitals, the cost impact is still substantial in the absence of cost savings associated with improved efficiency or improved patient safety.  
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70% of residents were looking forward to CPOE and 28% resist on transitioning to CPOE during during the pre-implementation survey. At 12 months post-implementation, 80% of residents favored CPOE over paper ordering and only 3.33% wished to revert to paper ordering. In terms of time spent on ordering, at 6 months post-implementation, residents reported an increased time while at 12 months post-implementation, the difference in perceived time to complete admission orders was insignificant.  
  
 
== Conclusion ==
 
== Conclusion ==
Implementation of CPOE in rural or critical access hospitals may lead to a big financial burden. Adoption of CPOE may be financially infeasible for small hospitals in the absence of increased revenue or subsidies from third parties.  
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Overall, pediatric residents demonstrated a preference for CPOE. The majority of residents found CDS stools helpful and felt more knowledgeable about current guidelines. EMR resources are likely to be important factors for residents' future employment opportunities.
  
 
== Comments ==
 
== Comments ==
I agree that implementation of CPOE is costly. However, the authors estimated cost with a linear model using number of beds as a covariate which may not hold in reality since the size of practice usually is not the major factor determining CPOE cost. Also, this study was conducted before 2005 and would not reflect current state of CPOE implementation as CPOE systems are becoming more mature and cheaper.  
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This study showed CPOE had dominant benefits over paper based order entry. It is interesting to find that employment opportunities is also linked to residents' familiarity of health technology.
 
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== Related Articles ==
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[[Early cost and safety benefits of an inpatient electronic health record]]
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== References ==
 
== References ==
 
<references/>
 
<references/>

Revision as of 16:41, 11 November 2015

Background

Methods

Results

Conclusion

References


Second Review

This is a review of an article by Shriner et al, Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE [1]

Objective

To investigate the attitudes and perceptions of residents before and after the implementation of CPOE and CDS system.

Methods

Web-based survey was used to collect data from pediatric residents prior to CPOE implementation and at 6 months as well as at 12 months post implementation. The survey included a variety of multiple choice questions, free text response and Likert scale queries. Descriptive statistics was used to compare pre and post implementation results.

Results

70% of residents were looking forward to CPOE and 28% resist on transitioning to CPOE during during the pre-implementation survey. At 12 months post-implementation, 80% of residents favored CPOE over paper ordering and only 3.33% wished to revert to paper ordering. In terms of time spent on ordering, at 6 months post-implementation, residents reported an increased time while at 12 months post-implementation, the difference in perceived time to complete admission orders was insignificant.

Conclusion

Overall, pediatric residents demonstrated a preference for CPOE. The majority of residents found CDS stools helpful and felt more knowledgeable about current guidelines. EMR resources are likely to be important factors for residents' future employment opportunities.

Comments

This study showed CPOE had dominant benefits over paper based order entry. It is interesting to find that employment opportunities is also linked to residents' familiarity of health technology.

References

  1. Shriner, A. R., & Webber, E. C. (2014). Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE. Appl Clin Inform, 5(3), 721-730.