Computerized Provider Order Entry (CPOE): Benefits, Challenges, and Problem Statement

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Computerized provider order entry (CPOE) is an innovation utilized by clinicians to straightforwardly and carefully enter medications, lab, radiology, and different orders into a computer system or electronic mobile device, from which the requests are transmitted electronically to the separate office or administration for execution. CPOE supports institutionalized, evidence- based, and legible requests and, through clinical decision support (CDS), can improve quality and wellbeing by decreasing medication and different errors at various phases of the order management process. It can likewise lessen excess or repeat testing (Gellert; Catzoela; Patel; Bruner; Friedman, 2017).

The Health Information Management Systems Society (HIMSS) defines CPOE as: “An order entry application specifically designed to assist practitioners in creating and managing medical orders for patient services or medications. This application has special electronic signature, workflow, and rules engine functions that reduce or eliminate medical errors associated with physician ordering processes”

Benefits of CPOE

Advantages related with implementing a CPOE system is:

the decline in adverse drug events (ADEs) and furthermore the decrease in prescription mistakes, for example, wrong dosages, deficient orders, duplicate treatments, drug adversities and hypersensitivities, abbreviation blunders, and illegible orders because of poor penmanship from the providers

CPOE may likewise lessen prescription override administer rates from automated dispensing cabinets (ADCs),

improve the mean turnaround time (TAT) for first-dose meds, increment profitability, and the measure of saving time from medicine dispensing to prescription organization (Kruse, & Goetz, 2015).

Problem Statement

Computerized physician order entry (CPOE) frameworks are one of the clinical information system (CIS) arrangements executed in hospitals and clinics to improve patient safety and reduce medical errors. However, the consequences of the research around it are mixed. While a few investigations have announced positive effects on reduced medical error and patient wellbeing, other studies have indicated that these frameworks don't generally diminish medical errors, and they may even increase medical errors and death rates (Peikari, Zakaria, Yasin, Shah, & Elhissi, 2013). In any case, ease of use testing has exhibited that CPOE frameworks with clinical decision support still enable unsafe orders to be entered and processed, and that clinicians can sidestep safety features with little trouble. However even as CPOE improves a few parts of patient wellbeing, there is developing acknowledgment that it can likewise prompt new security concerns—especially if the framework is poorly designed. Therefore, there is a need to contemplate the effect of CPOE on explicit prescribing errors instead of comprehensively broad medical errors (Agency for Healthcare Research and Quality [AHRQ], 2012).

Challenges with CPOE

More or new work for clinicians: One study conducted after implementation of a business CPOE framework found that the framework expected clinicians to perform numerous new tasks, expanding intellectual load and diminishing effectiveness, and along these lines raising the potential for blunder. In that review, albeit by and large errors diminished, issues identified with the CPOE framework itself represented practically 50% of endorsing blunders after implementation (Agency for Healthcare Research and Quality [AHRQ], 2012).

Numerous CPOE frameworks slow the speed at which clinicians can do the clinical documentation and ordering process.

Never-ending system demands; Complex collaborations among the various programming highlights can make the installation both unmanageable and obsolete, to such an extent that the framework should be supplanted with a more current (and "cleaner") form.

Unfavorable workflow issues: New workflows can cause surprising duplications or inconsistencies among orders, to the point of jeopardizing patient care.

When CPOE frameworks are inadequately coordinated with other clinical information systems, clinicians discover it tedious to sign in to various frameworks utilizing distinctive record names and passwords.

Unfavorable changes in communication patterns and practices: CPOE frameworks can worsen issues identified with the use of verbal orders related to framework section; a few foundations have gone to the extent of restricting verbal requests aside from on emergency situations (Campbell, Sittig, Ash, Guappone, & Dykstra, 2006).