CPOE
Computerized physician order entry (CPOE) is a technology that allows physicians to enter orders, medications, or procedures directly into the computer instead of handwriting them. [1] The electronic medical system transmits the order to the appropriate department or individual so the order can be carried out. [2]
Contents
- 1 Computerized physician order entry
- 2 System Selection
- 3 System Configuration
- 4 Implementation Strategies
- 5 Physical Computing Environment
- 6 Emergency Department Setting
- 7 Mobile Computers
- 8 Monitoring and Evaluation
- 9 Unintended Consequences
Computerized physician order entry
CPOE History
Project Governance
Readiness Assessment
Setting up the Project Team
System Selection
Creating the Request for Proposals
Creating the Request for Proposals
Making Site Visits
System Configuration
The system should be configured correctly for ease of use and security.
- Passwords should be secure yet easy to remember. [3]
- Co-signatures allows for multiple levels of function and security (eg, an RN can place an order but only with a signature from a physician)
- Time-out settings prevent accidental unauthorized access.
- Clinical staff are sometimes reluctant to switch from paper to electronics. Active encouragement, additional training, and a deadline to fully integrate into CPOE increases compliance.
Dealing with Patient Transfers
Dealing with Patient Transfers
Pre-Admission Order Policies
Creating Order Sets
Using Controlled Medical Terminologies
Using Controlled Medical Terminologies
RxNorm
LOINC
Logical Observation Identifiers Names and Codes
Unified Medical Language System - UMLS
Systematized Nomenclature of Medicine - Clinical Terms - SNOMED-CT
CPOE Regulatory Problems|Regulatory Problems
AMDIS Response to the Federal Tamper-Resistant Rx Law
AMDIS Response to the Federal Tamper-Resistant Rx Law
Success Factors
CPOE and Meaningful Use
Implementation Strategies
Some organizations hire computer scribes who follow and enter orders for physicians. This allows reluctant physicians to also comply with CPOE.
Big Bang vs. Incremental Roll-out
Big Bang vs. Incremental Roll-out
Whether, when, and how to remove paper from the process?
Whether, when, and how to remove paper from the process?
Physical Computing Environment
The physical computing environment is important. Effect of Computers in the Examination Room
Inpatient Setting
Wall Mounted Computers
Desktop Computers
Mobile Computers
Laptop Computers
Tablet Computers
Handheld Computers
Infection Control Concerns
Emergency Department Setting
Mobile Computers
Monitoring and Evaluation
Routine Methods
Study Designs
Leapfrog CPOE Standard
Consensus recommendations on Measurements
Consensus recommendations on Measurements
Unintended Consequences
Unintended errors fall into two main categories: [4]
- Error in entering and retrieving information
- Communication and coordination
Increased Resource Utilization
Increased Resource Utilization
Emotional Reactions
Increased Reliance on Technology
Increased Reliance on Technology
Prescribers’ Responses to Alerts During Medication Ordering in the Long Term Care Setting
Prescribers’ Responses to Alerts During Medication Ordering in the Long Term Care Setting