Personal order set

A common question is whether an organization should allow individual clinicians to create "personal order sets"? In my opinion the current consensus is NO! for several reasons which are well explained in the text below from the CMIO of a leading medical center in central Pennsylvania.

We began creating order sets and note templates 12 years ago. At that

time, we told people that one of the benefits of the EHR was the ability
to build tools that fit one's specific style of practice. Our
experience was that very few of the tools were used, even in the case of
sophisticate tool builders. And with 1500+ order sets, there was no
accountable validation process at the outset nor accountable curation process to
keep them demonstrably current.

When we began building inpatient note templates and order sets, our

organization and the quality-and-safety climate had changed enough that we
changed our policy. Now order-set and note-template topics are
identified by departmental, service-line, and quality leadership; tool
outlines are pre-vetted by medical records, quality, medical education, billing,
pharmacy, and informatics; contents are provided by domain experts who
are nominated by the appropriate chair and who work on behalf of the
department, service-line, or enterprise (in the case of tools that span
groups); and the tools are post-vetted by the same vetting groups (who
recommend large numbers of changes). 

The tools that have been developed this way represent our

standard of practice. We have op-note templates and order sets (in one
department) that have been live for 2-4 years. The early indications are that
providers increasingly appreciate tools that they can rely on to help
them achieve the performance measures (internal and external) that are
increasingly being required of them. (We are working on setting up a
software-supported system that will semi-automate the development and
curation processes.)