Difference between revisions of "CPOE History"

Revision as of 05:08, 24 November 2009

The history of CPOE is a recent history; indeed, we are still learning the lessons of the very first implementations, and very few standards exist on any aspect of this type of information system as of yet. The story begins with Lockheed Martin, who developed the first CPOE system (then simply called the "medical information system"). This system provided almost no clinical decision support (no alerts, automatic calculations, or suggestions), but it did allow physicians to quickly order medications with a few simple clicks. It was implemented in the El Camino hospital in Mountain View, California, in 1971, and took two years to become fully operational, with "go live" in June 1973. This system eventually became the basis for the Eclipsys company's original CPOE product, E7000.

Despite the reported success of the 9medical information system in El Camino Hospital (citation), others were slow to follow. Riegenstrief began implementing a CPOE at Wishard Memorial Hospital in 1984. This system was required keyboard input, but had a bit more decision support than the El Camino system, allowing automatic reordering and alerts for known adverse interactions. In 1988, the LDS Hospital in Salt Lake came out with HELP, a blood-product-specific CPOE system that added an additional "standing orders" feature which automatically placed orders for specific procedures that were added over time.

The period from 1995 to 2005 was a time of serious growth in the commercial side of CPOE, as vendors began to realize what a small proportion of the market was being served. These included both large companies wanting to break into healthcare and utterly new companies starting with their first product: Cerner came out with Millenium, Eclypsis changed their E7000 line into SCM, Siemens launched InVision, Meditech announced Magic, EpicCare was released, McKesson developed Horizon, and GE was just finishing Centricity. Each claimed to be the definitive product, and claimed that a different piece of the puzzle was paramount. Epic offered the most accurate decision support, McKesson the most workflow-centric interface design, and Eclypsis the largest variety of ordering methods and products; GE, of course, tried to be all things to all people and develop a standard by which the rest would have to abide.

Timeline:

1966 - Lockheed Martin begins work on the Medical Information System 1973 - El Camino Hospital rolls out the first experimental CPOE system

1995 - Eclipsys (then called Integrated Healthcare Solutions, Inc.) was founded, building its primary product on the principles of the El Camino CPOE

2003 - Cerner launches Millennium, its primary CPOE product

References:

Submitted by James McKanna