scholarly journals A novel method to retrieve alerts from a homegrown Computerized Physician Order Entry (CPOE) system of an academic medical center: Comprehensive alert characteristic analysis

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 ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Computerized Physician Order Entry ◽  
Order Entry ◽  
Characteristic Analysis ◽  
Hospital System ◽  
Hospital Administrators ◽  
Academic Medical ◽  
Novel Method ◽  
Physician Order Entry

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.

scholarly journals A Tool to Retrieve Alert Dwell Time from a Homegrown Computerized Physician Order Entry (CPOE) System of an Academic Medical Center: An Exploratory Analysis

2021 ◽  
Vol 11 (24) ◽  
pp. 12004
Author(s):  
Shuo-Chen Chien ◽  
Yen-Po Chin ◽  
Chang-Ho Yoon ◽  
Chun-You Chen ◽  
Chun-Kung Hsu ◽  
...  
Keyword(s):  
Dwell Time ◽  
Medical Center ◽  
Academic Medical Center ◽  
Exploratory Analysis ◽  
Computerized Physician Order Entry ◽  
Order Entry ◽  
Professional Groups ◽  
Academic Medical ◽  
Physician Order Entry ◽  
The Impact

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.

scholarly journals Immediate Benefits Realized Following Implementation of Physician Order Entry at an Academic Medical Center

2002 ◽  
Vol 9 (5) ◽  
pp. 529-539 ◽  
Author(s):  
H. S. Mekhjian ◽  
R. R. Kumar ◽  
L. Kuehn ◽  
T. D. Bentley ◽  
P. Teater ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Order Entry ◽  
Academic Medical ◽  
Physician Order Entry

Analysis of dosing-button compliance

2019 ◽  
Vol 76 (21) ◽  
pp. 1770-1776
Author(s):  
Mary Frances Picone ◽  
James P New ◽  
Matthew Hunter Johnson ◽  
Nihal Nilesh Desai ◽  
Matthew Hebbard
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Order Entry ◽  
Exclusion Criteria ◽  
Computerized Provider Order Entry ◽  
High Performing ◽  
Academic Medical ◽  
Secondary Study ◽  
High Level ◽  
Initial Medication

Abstract Purpose A project was undertaken at an academic medical center to assess use of available dosing buttons within the computerized provider-order-entry (CPOE) system in order to identify opportunities for optimization of medication builds. Methods A retrospective observational study was conducted to identify medication records within a CPOE system meeting prespecified inclusion and exclusion criteria. A report capturing all inpatient adult medication orders associated with the identified medication records over a 6-month period was generated. The primary endpoint was percent dosing-button compliance, calculated as the number of orders with doses consistent with existing dosing-button options divided by the total number of orders during the study period. Secondary study objectives included a comparison of high- and low-performing medication record samples and identification of potential reasons for lack of dosing-button use. Results A total of 2,506 CPOE medication records associated with a total of 694,877 medication orders entered during the study period were analyzed. Median percent dosing-button compliance was 99.92% (interquartile range, 83.33–100%). High-performing records (n = 1243) were more likely to be associated with anti-infective medications (p = 0.041) and medications not on formulary at the study institution (p < 0.001). Medications in the sample of poor-performing CPOE records (n = 614) were more likely to be agents delivered via the i.v. route (p < 0.001). There were 45 records for which poor dosing-button compliance was attributed to lack of a clinically reasonable dosing option. Conclusion A high level of dosing-button compliance was demonstrated despite the lack of routine revalidation of dosing buttons after initial medication builds. Some opportunity for optimization was identified during the project, which established a quality assurance method to facilitate future auditing of medication builds.

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 ◽  
...  
Keyword(s):  
Health Systems ◽  
Medical Center ◽  
Medication Management ◽  
Lessons Learned ◽  
Medication Cost ◽  
Computerized Physician Order Entry ◽  
Management Process ◽  
Order Entry ◽  
Physician Order Entry

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.

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