Computerized Physician Order Entry System

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Table of Contents

Definition of a CPOES
Technology used and System development
References

Proper medical care is a basic need for all humankind. The distribution of quality medical care is dependent on many factors. Well-trained health personnel, health administrators and an active support staff are a necessity. However, in spite of their professionalism, errors still arise (Bates, 2002).

This necessitates adoption of IT to help in tracking patients’ medical history and related literature. While this shared resources addressed many problems, it failed to address other relevant sources of errors.

Misapprehension of handwritten instructions, dosage errors due to illegible decimal places, unnoticed drug interaction and dissimilarities in medical practice were common with traditional methods (Williams, 2002). CPOES is a computer system that addresses these problems. This paper explicates its meaning, how to develop and implement it, and its use in hospitals and other medical institutions. It also addresses such issues as legislation governing the use of CPOES and its potential success.

Definition of a CPOES

CPOES is a computer based application program. It allows doctors and other lawful users’ direct entry into a computer, analytical tests, medications, patient care, and referrals (Bates, 2002). It forms part of a broad medical database called health information system (HIS). HIS is a special catalog that contains all the information regarding patients in a given region.

Depending on the kind of information structure desired by the authorities, HIS can be specific to a given health institution only, a database serving a state or an entire country. In this regard, CPOES performs the function of an access medium to the centralized database.

Generally, CPOES is an application program installed in computers used in hospitals and ambulances. Usually, there is a constant need of recording medical data. According to Dixon et al. (2009), CPOE is software that ensures orders are perfectly captured and implemented. It provides a guarded way of making orders and subscription.

Like any computer application program, it requires the support of other programs to accomplish its functions. In hospitals, highly robust software called “clinical decision support system” exists with CPOES. Clinical decision support system (CDSS) is robust data crunching software that helps in analyzing the orders from CPOES to ensure correct input from the Doctor.

CPOES prompts doctors for inputs through a window and displays the required output. CDSS logically analyze theses orders in the background and forwards the desired output to CPOES for display. This help Physicians reduce improper drug prescription and other faults while at the same time lowering costs.

Technology used and System development

The development of a CPOES is a complex procedure. Like any other application program, it undergoes the application development life cycle. Firstly, it starts with problem definition. This entails comprehensive statements describing CPOES. The second stage is the program design. This involves outlaying stepwise Structural description of the CPOES. The next stages involve coding the program, debugging it, testing, and documentation. Finally, maintenance and offering extension redesign occur.

The whole process necessitates specialists with vast knowledge in the fields of IT and medicine. The physician involved at the design stage is responsible for the required medical inputs. He helps in identifying the needed medical procedures for coding. In Williams (2002), the physician-driven CPOES design is preferable.

In this design, the three core activities that occupy a physician’s daily life are considerable. Initially, the provision of patient care, which involves activities like clinical procedures, filling in patient information, and communication to patients occur.

Secondly, physicians need to ensure that they comply with the requirements of their professional associations. Lastly, they need to manage their time properly, balancing between administrative and patient care activities. These activities provide the primary data and information required in designing the CPOES.

Hospitals already have a HIS. This is a database containing the patients’ health records. In most nations, there exists a national database containing the health records of all citizens. In such a case, the national database provides the backbone on which the CPOES exists. In this manner, the CPOES is crucial in updating, editing, and displaying the records in the database.

According to Ferranti (2011), a typical CPOES comprehensively manages orders that encompass vast medical disciplines. Such a system should provide an interactive view that enables robust data entry and manipulation. The standard java-based desktop client is usable to query the HIS server.

The HIS server is able to run on an oracle 10 database. Oracle DB 10 is a relational database. Charts and tables containing patient information need storage in the database. Controlled access to the system ensures that only accredited professionals manipulate its contents.

System use

There are enormous uses of the CPOES in a hospital setup. To begin with, they enable physicians to make orders directly into a computer instead of writing on a paper. Secondly, CPOES have an embedded clinical decision support system that helps in verifying orders. In this way, medical errors resulting from orders are stoppable.

The clinical order support system ensures adherence to the stipulated standards. This uplifts the service quality offered by the facility. Centralized databases are a common resource accessed by all departments. This augments interdepartmental communication (Kuperman, 2003). The data captured by the CPOES is particularly vital in research, excellence evaluation, and judgments by the management.

The system Users

In Bates (2002) report, CPOES provides services to many professionals. Firstly, Physicians finds it an indispensable tool for making and evaluating orders. Hospital administrators use it to extract information vital for decision-making. It offers information regarding quality of service. The representation of patients’ data in tabular form makes it easy to comprehend and sketch conclusions.

Legislation Surrounding its Implementation

According to Williams’ (2002), the use of CPOES must follow the regulations concerning the use of IT in health facilities. It helps in respecting the patients’ privacy. Additionally, doctors should hold to their certified code of conduct constantly.

The potential success of technology in the future of HIS management

In the past two decades, the implementation of health information systems has met several barriers. These barriers incorporate inadequate financing, unclear implementation road maps and the existence of incompatible technologies. Presently, there exist health statistics systems in hospital (Bates, 2002).

However, the adoption of the CPOES is facing similar hitches encountered the past decades. Commercial CPOES have their own undoing. Majority are sluggish. Secondly, the need for customized applications by different institutions has proved hugely expensive. Off the shelf CPEOS, still require a lot of modification to suit hospital needs.

Despite that, the enthusiasm of enhanced quality, easier ordering and access to information that shapes decisions has swayed a few hospitals to adopt it. According to Bates (2002), to enhance the acceptance and adoption of PCOES a different direction should is necessary.

The negative views by some doctors are changeable through enhanced research on the use of CPOES. Improvement of the technology is also required to make it faster. This will make using CPOES more enjoyable and enhances its value. Lastly, appropriate legislation is required to entrench CPOES in the health provisions (Bates, 2002). In Dixon’s findings, the training of health experts on CPOES is extraordinarily important.

He argues that health workers would readily accept a technology they recognize. Secondly, he noticed that some institutions were understaffed. The problem of under staffing meant that few workers who can afford the time to learn about CPOES.

A systematically designed workflow would make the adoption of CPOES easier. Other factors considered comprise systematic resource allocation within the institution and working with vendors to uplift the performance of CPOES. Future technical follow-ups are vital for the application to provide a long time of service.

System Implementation Plan

To implement a CPOES in a physician office setting, there should be the consideration of certain factors. An analysis of the current system is vital. This analysis aims at establishing the compatibility of this current system. The results would help establish whether a complete system overhaul might is compulsory.

The second stage is to reorganize the old system. This involves aligning it to the new system. In addition, converting data and file formats to the new format (Bates, 2002). The next phase involves hardware and programs installation. Train staff on the new application and its operations. Show the difference between the old system and the new one. Offer advice on new specialized staff if need be.

These are Staff with an excellent understanding of medical and information technology procedures. Personnel involved in the procedure from the onset of execution would have additional advantage. The workflow as defined by the CPOES is truly vital in its acceptance. CPOES changes among entail, authorization procedures, review and execution of orders.

The physician’s office is a decidedly busy place. Thus, it is imperative to allocate time allowing other operations within the premise. Maintaining of contact with vendors and suppliers is vital. The customer should possess a user manual of the system allowing internal resolution of the hitches that emerge.

References

Bates, W. & Doolan, D. (2002). Computerized Physician Order Entry Systems in Hospitals: Mandates and Incentives. Web.

Dixon, E. & Zafar, A. (2009). Inpatient Computerized Provider Order Entry (CPOE) Findings from the AHRQ Health IT Portfolio. Web.

Ferranti, M., Horvath, M., Jansen, J., Schellenberger, P., Brown, T., DeRienzo, M. & Ahmed, (2011). Using a computerized provider order entry system to meet the unique prescribing needs of children: description of an advanced dosing model. Web.

Kuperman, J. ( 2003). Computer Physician Order Entry: Benefits, Costs, and Issues. Annals of Internal Medicine, Vol. 139.

Williams, B. (2002). Successful Computerized Physician Order Entry System Implementation: Tools to Support Physician-Driven Design and Adoption. HealthCare Leadership & Management Report. Vol. 10. Is. 10.

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