Case Study: Challenges, Successes and Lessons Learned from Implementing Computerized Physician Order Entry (CPOE) at Two Distinct Health Systems: Implications of CPOE on the Pharmacy and the Medication-Use Process

2005 ◽  
Vol 40 (5) ◽  
pp. 420-429 ◽  
Author(s):  
John Manzo ◽  
Mark J. Sinnett ◽  
Frank Sosnowski ◽  
Robert Begliomini ◽  
Jill Green ◽  
...  

The purpose of this case study is to provide an understanding of the divergent experiences, challenges, and successes associated with implementing Computerized Physician Order Entry (CPOE) at two distinct health systems utilizing the same software vendor. Pharmacy leaders at Lehigh Valley Hospital and Health Network in Allentown, PA and Montefiore Medical Center in the Bronx, NY describe the various strategies deployed for CPOE planning and implementation, the outcomes and impacts of CPOE implementation, and valuable experience. Improvements and efficiencies in the medication management process and time savings will be described. Additionally, reductions in medication prescribing errors and enhancements in medication cost savings secondary to improved medication utilization are delineated. The authors conclude that while the challenges associated with planning and implementing CPOE for medication management and its impact on the pharmacy are great, pharmacist involvement early in the strategic planning is vital to ensure a successful and safer electronic medication management process.

2021 ◽  
Vol 11 (24) ◽  
pp. 12004
Author(s):  
Shuo-Chen Chien ◽  
Yen-Po Chin ◽  
Chang-Ho Yoon ◽  
Chun-You Chen ◽  
Chun-Kung Hsu ◽  
...  

Alert dwell time, defined as the time elapsed from the generation of an interruptive alert to its closure, has rarely been used to describe the time required by clinicians to respond to interruptive alerts. Our study aimed to develop a tool to retrieve alert dwell times from a homegrown CPOE (computerized physician order entry) system, and to conduct exploratory analysis on the impact of various alert characteristics on alert dwell time. Additionally, we compared this impact between various professional groups. With these aims, a dominant window detector was developed using the Golang programming language and was implemented to collect all alert dwell times from the homegrown CPOE system of a 726-bed, Taiwanese academic medical center from December 2019 to February 2021. Overall, 3,737,697 interruptive alerts were collected. Correlation analysis was performed for alerts corresponding to the 100 most frequent alert categories. Our results showed that there was a negative correlation (ρ = −0.244, p = 0.015) between the number of alerts and alert dwell times. Alert dwell times were strongly correlated between different professional groups (physician vs. nurse, ρ = 0.739, p < 0.001). A tool that retrieves alert dwell times can provide important insights to hospitals attempting to improve clinical workflows.


2010 ◽  
Vol 29 (4) ◽  
pp. 235-241 ◽  
Author(s):  
Anne Ramirez ◽  
Debra Carlson ◽  
Carey Estes

Implementation of computer physician order entry (CPOE) demands planning, teamwork, and a steep learning curve. The nurse-driven team at the hospital unit level is pivotal to a successful launch. This article describes the experience of one NICU in planning, building, training, and implementing CPOE. Pitfalls and lessons learned are described. Communication between the nurse team at the unit and the clinical informatics team needs to be ongoing. Self-paced training with realistic practice scenarios and one-on-one “view then practice” modules help ease the transition. Many issues are not apparent until after CPOE has been implemented, and it is vital to have a mechanism to fix problems quickly. We describe the experience of “going live” and the reality of day-to-day order entry.


PEDIATRICS ◽  
2013 ◽  
Vol 131 (Supplement 1) ◽  
pp. S60-S67 ◽  
Author(s):  
Michael G. Leu ◽  
Sheryl A. Morelli ◽  
Oi-Yan Chung ◽  
Shanon Radford

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246597
Author(s):  
Shuo-Chen Chien ◽  
Yen-Po (Harvey) Chin ◽  
Chang Ho Yoon ◽  
Md. Mohaimenul Islam ◽  
Wen-Shan Jian ◽  
...  

Background The collection and analysis of alert logs are necessary for hospital administrators to understand the types and distribution of alert categories within the organization and reduce alert fatigue. However, this is not readily available in most homegrown Computerized Physician Order Entry (CPOE) systems. Objective To present a novel method that can collect alert information from a homegrown CPOE system (at an academic medical center in Taiwan) and conduct a comprehensive analysis of the number of alerts triggered and alert characteristics. Methods An alert log collector was developed using the Golang programming language and was implemented to collect all triggered interruptive alerts from a homegrown CPOE system of a 726-bed academic medical center from November 2017 to June 2018. Two physicians categorized the alerts from the log collector as either clinical or non-clinical (administrative). Results Overall, 1,625,341 interruptive alerts were collected and classified into 1,474 different categories based on message content. The sum of the top 20, 50, and 100 categories of most frequently triggered alerts accounted for approximately 80, 90 and 97 percent of the total triggered alerts, respectively. Among alerts from the 100 most frequently triggered categories, 1,266,818 (80.2%) were administrative and 312,593 (19.8%) were clinical alerts. Conclusion We have successfully developed an alert log collector that can serve as an extended function to retrieve alerts from a homegrown CPOE system. The insight generated from the present study could also potentially bring value to hospital system designers and hospital administrators when redesigning their CPOE system.


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