Difference between revisions of "Default settings of computerized physician order entry system order sets drive ordering habits"

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Article Review
 
Article Review
Olson J, Hollenbeak C, Donaldson K, Abendroth T, Castellani W. Default settings of computerized physician order entry system order sets drive ordering habits. J Pathol Inform. 2015 Mar 24;6:16. doi: 10.4103/2153-3539.153916. eCollection 2015.  <ref name= "OrderSets">Olson J1, Hollenbeak C2, Donaldson K3, Abendroth T3, Castellani W3. (2015) Default settings of computerized physician order entry system order sets drive ordering habits. http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pubmed/25838968</ref>
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Olson J, Hollenbeak C, Donaldson K, Abendroth T, Castellani W. Default settings of computerized physician order entry system order sets drive ordering habits. J Pathol Inform. 2015 Mar 24;6:16. doi: 10.4103/2153-3539.153916. eCollection 2015.  <ref name= "OrderSets">Olson J, Hollenbeak C, Donaldson K3, Abendroth T, Castellani W. (2015). Default settings of computerized physician order entry system order sets drive ordering habits. http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pubmed/25838968</ref>
  
 
== Introduction ==
 
== Introduction ==

Revision as of 05:22, 1 October 2015

Article Review Olson J, Hollenbeak C, Donaldson K, Abendroth T, Castellani W. Default settings of computerized physician order entry system order sets drive ordering habits. J Pathol Inform. 2015 Mar 24;6:16. doi: 10.4103/2153-3539.153916. eCollection 2015. [1]

Introduction

Computerized physician order entry (CPOE) sytems are quickly becoming widely used and groups of orders ("order sets") to allow for easy order input are a common feature. Order sets are groups of orders commonly used in for condition-specific or situation specific encounters. The order set components (specific order) can be set up to be "preselected" or "defaulted-on" whenever the order set is used while other components might be "optional" or "defaulted-off". Physicians create order habits based on their needs and incorporate order sets to their workflow of practice.[1]

Methods

Order set for post transfusion orders were utilized for this study in an effort to improve quality. Changes to two orders were done; posttransfusion hematocrits and platelet count were modified from "optional" to "preselected". The default settings for platelets count was later changed back to "optional", allowing for a natural experiment to study the effect of the default selections of an order set on clinician ordering habits.

Results

  • Initial percentage:
hematocrits orders 8.3% 
platelets count orders 7%
  • After default order set change
hematocrits orders 57.4%
platelets count orders 59.4%
  • Platelet count order changed back to initial set up
platelet count orders 7.5%

There was a significant difference in the rate at which posttransfusion counts were obtained between the intervention periods and when the platelet count was defaulted "optional" and "preselected".

Comments

It is important to mentioned that the setting in which this study was conducted was a academic hospital in which residents do the majority of the ordering. Order set may be less questioned than in other setting where physician ordering habits are more entrenched. Clinicians do rely in CPOE to aid them in ordering. Further studies need to be conducted to determine the usability and risks of utilizing order sets.


Reference

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