Order Set

Order sets can be defined as a group of related orders which a physician can place with a few keystrokes or mouse clicks.(1) Therefore, they allow users to issue prepackaged groups of orders that apply to a specified diagnosis or a particular period of time.(2) One of the main impetuses for order sets comes from the need to improve user acceptance of Computer-based Physician Order Entry, by decreasing the time physicians require to enter orders. In fact, it was shown by Anderson that using order sets could reduce both time spent entering orders and terminal usage.(3)

Individuals may create their own order sets by a variety of methods, and some are even available on the internet.(4) In addition, some institutions have developed modifiable templates that allow physicians to customize their own order sets.(1) Mostly, however, order sets are developed by a group of physicians or a department with a particular clinical focus. They then come up with a set of diagnostic and treatment options that encompass current best practices. This latter approach results in a more limited number of order sets, and is easier to manage.(3,4)

There are many reported benefits of order sets as outlined by Levine(2): 1. Reduction of transcription errors. 2. Promotion of adherence to consistent standards of care 3. Focus attention upon unique features of a patient. 4. Quicker order entry 5. Reduction in delays due to inconsistent or incomplete orders

Order sets represent a potential solution to the time constraints of busy physicians and may even improve quality and safety. Obstacles to overcome would include physician acceptance, costs of creation and maintenance, and user interface issues.

1. Franklin, MJ, et al, Modifiable Templates Facilitate Customization of Physician Order Entry, http://www.amia.org/pubs/symposia/D005222.PDF. 2. Sittig, DF, and Stead, WW, Computer-based Order Entry: The State of the Art, J Am Med Informatics Assoc., 1994;1:108-123. 3. Anderson, JG, et al, Physician Utilization of a hospital information system: a computer simulation model. Pric Annu Symp Compu Appl Med Care, IEEE, 1988;12:858-861. 4. Southern Ohio Medical Center, http://www.somc.org/for_doctors/orders/bonzo/