CPOE Common Mistakes

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Hiding Paper Order Sheets

In an attempt to "encourage" clinicians to use CPOE systems, organizations have tried various strategies. For example, one organization decided that since we are not going to mandate CPOE, we’ll at least make it difficult for them to use paper by hiding their order sheets. That was a mistake, because what happened was, the ward clerk got orders on a napkin and you can’t have a napkin in the medical-legal chart.

There is a better method which has been applied successfully. The CPOE is made live in parallel with paper orders. Physicians could choose between these methods, or could mix and match. Simultaneously, physicians are given education on the CPOE, and hand-holding to create order sets. After two to three months, the physicians are notified that in thirty days paper orders will no longer be accepted. The result was a successful conversion to CPOE with loss of only two physicians to resignation (1%). These physicians later rejoined the staff. It is not possible to reliably have computerized and paper orders for long because there may be contradictory orders present. CPOE are noted immediately, paper orders, whenever. Orders on napkins are disregarded.