Evaluation of outcomes before and after electronic medical record (EMR) and computerized physician order entry (CPOE) system implementation in an outpatient oncology setting

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17058-17058 ◽  
Author(s):  
C. A. Harshberger ◽  
B. Brockstein ◽  
G. Carro ◽  
W. Jiang ◽  
W. Spath ◽  
...  
Keyword(s):  
Medical Record ◽  
User Satisfaction ◽  
Cancer Center ◽  
Computerized Physician Order Entry ◽  
System Implementation ◽  
Order Entry ◽  
Record System ◽  
Before And After ◽  
Data Points ◽  
Physician Order Entry

17058 Background: Computerized physician order entry (CPOE) in electronic medical records (EMR) has been recognized as an important tool in optimal health care provision that can reduce errors and improve safety. The objective of this study is to describe documentation completeness and user satisfaction of medical charts before and after outpatient oncology EMR/CPOE system implementation in a hospital based outpatient cancer center within three treatment sites and with sixteen physicians. Methods: A retrospective chart review was conducted on 32 randomly selected patients to date, who received one of the following regimens: FOLFOX, carboplatin-paclitaxel, CHOP-rituximab, or AC between 1999 and 2006. Charts were case matched with physician and regimen to compare documentation completeness. Completeness scores were assigned to each chart based on the number of documented data points found out of the 33 data points assessed. A user satisfaction survey of the paper chart and EMR/CPOE system was conducted among the physicians (n=16), nurses (n=43), and pharmacists (n=8) who worked with both systems. Results: The mean percentage of identified data points successfully found in the EMR/CPOE charts was 94% vs. 68% in the paper charts (p<0.001). Regimen complexity did not alter the number of data points found. The survey response rate was 64% and the results showed that satisfaction was statistically significant in favor of the EMR/CPOE system. The time required to find the data points will be assessed by having a physician, nurse, and pharmacist review the same charts. Data on 112 charts will be presented. Conclusions: Using EMR/CPOE systems improves completeness of medical record and chemotherapy order documentation and improves user satisfaction with the medical record system. No significant financial relationships to disclose.

scholarly journals Outcomes of Computerized Physician Order Entry in an Electronic Health Record After Implementation in an Outpatient Oncology Setting

2011 ◽  
Vol 7 (4) ◽  
pp. 233-237 ◽  
Author(s):  
Cara A. Harshberger ◽  
Abigail J. Harper ◽  
George W. Carro ◽  
Wayne E. Spath ◽  
Wendy C. Hui ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Medical Record ◽  
User Satisfaction ◽  
Computerized Physician Order Entry ◽  
Health Record ◽  
Order Entry ◽  
Record System ◽  
Medical Record System ◽  
Electronic Health ◽  
Physician Order Entry

EHR/CPOE systems improve completeness of medical record and chemotherapy order documentation, as well as user satisfaction with the medical record system.

Implementation of Computerized Physician Order Entry for Chemotherapy: A Latin American Experience

2018 ◽  
pp. 1-12
Author(s):  
Fernando S. Valencia ◽  
Rossana Ruiz ◽  
Silvia P. Neciosup ◽  
Luis A. Mas ◽  
Karina M. Aliaga ◽  
...  
Keyword(s):  
Latin American ◽  
Multidisciplinary Team ◽  
Warning System ◽  
Dose Calculation ◽  
Computerized Physician Order Entry ◽  
Order Entry ◽  
Record System ◽  
American Hospital ◽  
Outpatient Chemotherapy ◽  
Physician Order Entry

Purpose We describe the implementation process of a computerized physician order entry (CPOE) for outpatient chemotherapy at a Latin American hospital, with the intent of providing other institutions with general guidance and insight through our experience. Methods In 2012, under the direction of the Department of Medicine of the Instituto Nacional de Enfermedades Neoplásicas, a multidisciplinary team composed of oncologists, nurses, pharmacists, and informatics engineers was formed to develop software for a CPOE for chemotherapy within a preexistent homegrown electronic medical record system in various phases. This included mapping and redesigning processes in an entirely electronic format, integrating the needs of the user for the development of electronic order sets, developing a checkpoint and a warning system to minimize prescription errors, and finally, training all the staff in implementation of the system. Results A CPOE for outpatient chemotherapy was successfully implemented in 2016. We have successfully standardized 266 chemotherapy orders, including for both solid tumors and hematologic malignancies, on the basis of appropriate guidelines. The software is linked to laboratory results and allows entry of important details for the patient's safety, such as anthropometric information for an automatic dose calculation and ranges for safe prescription. In addition, it is linked to the nursing plan sheets. Finally, it is possible to assess and continuously monitor the complex process of chemotherapy prescription. Conclusion This is the first report of implementation of a CPOE for chemotherapy in our region. The system was designed by a multidisciplinary team with its own resources. Our experience demonstrates the feasibility of computerizing the chemotherapy prescription process, constituting a tangible example for other institutions with potential impact on patient care.

Improving adherence to the Epic Beacon ambulatory workflow

2016 ◽  
Vol 23 (4) ◽  
pp. 273-277 ◽  
Author(s):  
Ellen Chackunkal ◽  
Vishnuprabha Dhanapal Vogel ◽  
Meredith Grycki ◽  
Diana Kostoff
Keyword(s):  
Compliance Rate ◽  
Medication Administration ◽  
Computerized Physician Order Entry ◽  
Order Entry ◽  
Center Staff ◽  
Ambulatory Oncology ◽  
Before And After ◽  
Henry Ford ◽  
Quasi Experimental ◽  
Physician Order Entry

Computerized physician order entry has been shown to significantly improve chemotherapy safety by reducing the number of prescribing errors. Epic's Beacon Oncology Information System of computerized physician order entry and electronic medication administration was implemented in Henry Ford Health System's ambulatory oncology infusion centers on 9 November 2013. Since that time, compliance to the infusion workflow had not been assessed. The objective of this study was to optimize the current workflow and improve the compliance to this workflow in the ambulatory oncology setting. This study was a retrospective, quasi-experimental study which analyzed the composite workflow compliance rate of patient encounters from 9 to 23 November 2014. Based on this analysis, an intervention was identified and implemented in February 2015 to improve workflow compliance. The primary endpoint was to compare the composite compliance rate to the Beacon workflow before and after a pharmacy-initiated intervention. The intervention, which was education of infusion center staff, was initiated by ambulatory-based, oncology pharmacists and implemented by a multi-disciplinary team of pharmacists and nurses. The composite compliance rate was then reassessed for patient encounters from 2 to 13 March 2015 in order to analyze the effects of the determined intervention on compliance. The initial analysis in November 2014 revealed a composite compliance rate of 38%, and data analysis after the intervention revealed a statistically significant increase in the composite compliance rate to 83% ( p < 0.001). This study supports a pharmacist-initiated educational intervention can improve compliance to an ambulatory, oncology infusion workflow.

Risk analysis and user satisfaction after implementation of computerized physician order entry in Dutch hospitals

2012 ◽  
Vol 35 (2) ◽  
pp. 195-201 ◽  
Author(s):  
Willem van der Veen ◽  
Han J. J. de Gier ◽  
Tjerk van der Schaaf ◽  
Katja Taxis ◽  
Patricia M. L. A. van den Bemt
Keyword(s):  
Risk Analysis ◽  
User Satisfaction ◽  
Computerized Physician Order Entry ◽  
Order Entry ◽  
Physician Order Entry

scholarly journals Impact of Computerized Order Entry to Pharmacy Interface on Order-Infusion Pump Discrepancies

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Rebecca A. Russell ◽  
David Triscari ◽  
Kathy Murkowski ◽  
Matthew C. Scanlon
Keyword(s):  
Intensive Care Unit ◽  
Infusion Pump ◽  
Healthcare Delivery ◽  
Pediatric Intensive Care ◽  
Computerized Physician Order Entry ◽  
Order Entry ◽  
Computerized Order Entry ◽  
Before And After ◽  
Discrepancy Rate ◽  
Physician Order Entry

Background. The ability of safety technologies to decrease errors, harm, and risk to patients has yet to be demonstrated consistently. Objective. To compare discrepancies between medication and intravenous fluid (IVF) orders and bedside infusion pump settings within a pediatric intensive care unit (PICU) before and after implementation of an interface between computerized physician order entry (CPOE) and pharmacy systems. Methods. Within a 72-bed PICU, medication and IVF orders in the CPOE system and bedside infusion pump settings were collected. Rates of discrepancy were calculated and categorized by type. Results were compared to a study conducted prior to interface implementation. Expansion of PICU also occurred between study periods. Results. Of 455 observations, discrepancy rate decreased for IVF (p=0.01) compared to previous study. Overall discrepancy rate for medications was unchanged; however, medications infusing without an order decreased (p<0.01), and orders without corresponding infusion increased (p<0.05). Conclusions. Following implementation of an interface between CPOE and pharmacy systems, fewer discrepancies between IVF orders and infusion pump settings were observed. Discrepancies for medications did not change, and some types of discrepancies increased. In addition to interface implementation, changes in healthcare delivery and workflow related to ICU expansion contributed to observed changes.

We thought we would be perfect: medication errors before and after the initiation of Computerized Physician Order Entry

2015 ◽  
Vol 198 (1) ◽  
pp. 108-114 ◽  
Author(s):  
David Schwartzberg ◽  
Sasa Ivanovic ◽  
Sheetal Patel ◽  
Sathyaprasad C. Burjonrappa
Keyword(s):  
Medication Errors ◽  
Computerized Physician Order Entry ◽  
Order Entry ◽  
Before And After ◽  
Physician Order Entry
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