Impact of Computerized Prescriber Order Entry (CPOE) on Clinical Pharmacy Practice: A Hypothesis-Generating Study

2007 ◽  
Vol 42 (10) ◽  
pp. 931-938 ◽  
Author(s):  
Josephine S. Lai ◽  
Glenn Yokoyama ◽  
Clifton Louie ◽  
Jim Lightwood

Since the Institute of Medicine's 1999 landmark report on patient safety, much literature have been published to show the advantages and disadvantages of information systems such as computerized prescriber order entry (CPOE) on improving the delivery of health care. The primary end points of this study were to assess the potential impact of CPOE on patient safety, as well as pharmacy practice and profession—based on the experience and/or opinions of selected pharmacy leaders in California. A qualitative method using multidimensional scaling (MDS), a hypothesis generating tool, was used for data analysis. Most pharmacy leaders held positive opinions regarding the impact of CPOE on the pharmacy practice and the profession, with varying concerns regarding its impact on practice and safety. The MDS analysis showed that leaders from community hospitals held the most optimistic beliefs on CPOE's impact compared with leaders from the academic medical centers and government hospitals whom held concerns over the effect on pharmacy workflow, staffing requirements, and safety. Further studies with more observations should be conducted to assess the impact of CPOE on the pharmacy department.

2017 ◽  
Vol 9 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Jennifer S. Myers ◽  
Anjala V. Tess ◽  
Katherine McKinney ◽  
Glenn Rosenbluth ◽  
Vineet M. Arora ◽  
...  

2010 ◽  
Vol 67 (21) ◽  
pp. 1856-1861 ◽  
Author(s):  
Paul W. Bush ◽  
Daniel M. Ashby ◽  
Roy Guharoy ◽  
Scott Knoer ◽  
Steven Rough ◽  
...  

2017 ◽  
Vol 1 (S1) ◽  
pp. 38-39
Author(s):  
Molly Wasko ◽  
Elaine Morrato ◽  
Nicholas Kenyon ◽  
Suhrud Rajguru ◽  
Bruce Conway ◽  
...  

OBJECTIVES/SPECIFIC AIMS: The goal of this abstract/presentation is to share lessons learned from participation in the NIH SBIR I-Corps Train-The-Trainer Program, discuss our experiences offering programs at our local institutions, and communicate our plans to develop an I-Corps@NCATS program that can be disseminated across the CTSA network. We believe that an I-Corps@NCATS program will enhance the process of scientific translation by taking best practices from NSF I-Corps and adapting the program to meet the needs of biomedical scientists in academic medical centers. By integrating I-Corps@NCATS training, we hypothesize that the clinical and translational investigator base will be better prepared to identify new innovations and to accelerate translation through commercialization. METHODS/STUDY POPULATION: The diverse, interdisciplinary team of investigators involved in this project span 9 CTSA Hubs, including UAB, Rockefeller, UC Denver, HMC-Penn State, UMass, UC Davis, Emory/Georgia Tech, Miami and Michigan. This team was funded by NCATS in 2015–2016 to participate in the CTSA I-Corps Train-The-Trainer Program in conjunction with the NIH-SBIR/STTR I-Corps national program. The goals were to observe the curriculum, interact with and learn from the NSF National Teaching Team and begin implementation of similar programs at our home institutions. Our I-Corps@NCATS team has been holding monthly, and more recently weekly, conference calls to discuss our experiences implementing local programs and to develop a strategy for expanding CTSA offerings that include innovation and entrepreneurship. Our experience revealed several challenges with the existing NSF/NIH I-Corps program offerings: (1) there is no standard curriculum tailored to academic clinical and translational research and biomedical innovations in the life sciences, and (2) the training process to certify instructors in the I-Corps methodology is a much more rigorous and structured process than just observing an I-Corps program (eg, requires mentored training with a national NSF I-Corps trainer). Our team is proposing to address these gaps by taking best practices from NSF I-Corps and adapting the program to create the I-Corps@NCATS Program, tailored to meet the needs of researchers and clinicians in academic medical centers. RESULTS/ANTICIPATED RESULTS: There are 3 primary anticipated results of our project. First, develop a uniform curriculum for the I-Corps@NCATS Program using the National Teaching Team of experts from the NIH’s SBIR I-Corps program. Second, build the I-Corps@NCATS network capacity through a regional Train-The-Trainer Program. Third, develop a set of common metrics to evaluate the effectiveness and impact of the I-Corps@NCATS Program across the community of CTSA Hubs and their respective collaborative networks. DISCUSSION/SIGNIFICANCE OF IMPACT: Over the past 10 years, CTSA Hubs have accelerated science by creating/supporting programs that provide research infrastructure, informatics, pilot funding, education/training, and research navigator services to investigators. These investments help to ensure that we are “doing science right” using the best practices in clinical research. Even so, it is equally important to make investments to ensure that we are “doing the right science.” Are our investigators tackling research problems that our stakeholders, patients, and communities want and need, to make sure that our investments in science have real-world impact? In order to accelerate discoveries toward better health, scientists need to have a better way to understand the needs, wants and desires of the people for whom their research will serve, and how to overcome key obstacles along the path of innovation and commercialization. To fill this gap, we propose that the CTSA Hubs should include in their portfolio of activities a hands-on, lean startup program tailored after the highly successful NSF Innovation Corps (I-Corps) program. We hypothesize that by adapting the NSF I-Corps program to create an I-Corps@NCATS program tailored to medical research, we will better prepare our scientists and engineers to extend their focus beyond the laboratory and broaden the impact of their research. Investigators trained through I-Corps@NCATS are expected to be able to produce more innovative ideas, take a more informed perspective about how to evaluate the clinical and commercial impact of an idea, and quickly prototype and test new solutions in clinical settings.


CJEM ◽  
2016 ◽  
Vol 18 (4) ◽  
pp. 264-269 ◽  
Author(s):  
Andrew Gray ◽  
Christopher M.B. Fernandes ◽  
Kristine Van Aarsen ◽  
Melanie Columbus

AbstractObjectivesComputerized provider order entry (CPOE) has been established as a method to improve patient safety by avoiding medication errors; however, its effect on emergency department (ED) flow remains undefined. We examined the impact of CPOE implementation on three measures of ED throughput: wait time (WT), length of stay (LOS), and the proportion of patients that left without being seen (LWBS).MethodsWe conducted a retrospective cohort study of all ED patients of 18 years and older presenting to London Health Sciences Centre during July and August 2013 and 2014, before and after implementation of a CPOE system. The three primary variables were compared between time periods. Subgroup analyses were also conducted within each Canadian Triage and Acuity Scale (CTAS) level (1–5) individually, as well as for admitted patients only.ResultsA significant increase in WT of 5 minutes (p=0.036) and LOS of 10 minutes (p=0.001), and an increase in LWBS from 7.2% to 8.1% (p=0.002) was seen after CPOE implementation. Admitted patients’ LOS increased by 63 minutes (p<0.001), the WT of CTAS 3 and 5 patients increased by 6 minutes (p=0.001) and 39 minutes (p=0.005), and LWBS proportion increased significantly for CTAS 3–5 patients, from 24.3% to 42.0% (p<0.001) for CTAS 5 patients specifically.ConclusionsCPOE implementation detrimentally impacted all patient flow throughput measures that we examined. The most striking clinically relevant result was the increase in LOS of 63 minutes for admitted patients. This raises the question as to whether the potential detrimental effects to patient safety of CPOE implementation outweigh its benefits.


2009 ◽  
Vol 37 (12) ◽  
pp. 3091-3096 ◽  
Author(s):  
Babak Sarani ◽  
Seema Sonnad ◽  
Meredith R. Bergey ◽  
Joanne Phillips ◽  
Mary Kate Fitzpatrick ◽  
...  

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