Computerized Provider Order Entry (CPOE) System
Did you know that more than one million serious medication errors occur at US hospitals each year, resulting in the deaths of thousands of patients? The mistakes include administering the wrong drug, forgetting to mention a patient’s possible allergies, and drug overdose. New technology, promises to solve this deadly human error for good. Computerized provider order entry (CPOE) is a system designed for hospitals and physician offices to manage prescriptions, tests, treatments, and other medical orders. The intent behind this technology is to improve safety by decreasing errors in medication administration
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What Exactly is CPOE, And How Does It Work?
CPOE is a system that automates the process of entering orders into an electronic medical record (EMR). The CPOE allows physicians and pharmacists to store patient information, create medication lists, generate prescriptions, and enter new orders.
CPOE is a growing trend in the healthcare industry. The idea behind the technology is that having providers enter orders electronically rather than on paper will result in faster turnaround times for patients and reduced life-threatening errors.
Many CPOE systems work by the following six-step process:
1. A physician logs into an EMR.
2. Once logged in, the physician will see a list of patients on the screen.
3. The physician can select a patient and use the system to order prescriptions, lab work, and medical scans.
4. The system automatically validates the order against a patient’s medical history, health insurance plan, and other relevant data that has been stored in the system.
5. If no error is detected, the order will be sent to a product or service provider, typically a pharmacy or lab.
6. Finally, adding this order to the patient’s permanent records, expediting future reviews, orders, and access for care providers.
Benefits of CPOE
CPOE has been around for decades. But in recent years and with increased demand to digitize healthcare, CPOE has become more advanced and increasing its use by health providers worldwide. Today’s best CPOEs can offer the following benefits:
Three Benefits of CPOE
- Reduce Errors
- Increase Efficiency
- Cost Reduction
1. Reduce Errors.
A CPOE system saves time and works to ensure greater accuracy through the elimination of manual data entry. In turn, it increases patient safety. At least 7,000 people die in hospital-related medication errors annually in the US. With automation, reduces that fatal human error. Studies suggest that CPOE has the potential to reduce errors by 13% to 99%, depending on the technology’s practical use and level of integration with patient data.
CPOE automatically catches errors when medications are ordered because they are done using a computer, which matches the order with a patient’s profiles, including their lab results, general medical history, and insurance details saved in the system to ensure the patient receives the right prescription.
2. Increased efficiency:
Another benefit of CPOE is to increase efficiency. By eliminating manual data entry, the CPOE streamlines the ordering process, a vital feature for physicians who are already short on time. CPOE provides real-time access to inventory levels, pricing information, and more, you can make informed decisions about what your patients need. CPOE allows providers to spend less time on paperwork and more with patients. With orders being put into computers, CPOE ensures that no orders are lost and no ambiguities are caused by illegible handwriting.
Cost Reduction.
One of the most significant benefits of a CPOE is that it reduces costs for both patients and healthcare providers in the long term. A major study at the University of Washington, which looked at 400 midsize providers over five years, found that each provider can save hundreds of thousands of dollars by moving away from paper prescribing to a CPOE. The study concluded that adopting a CPOE is an “excellent value for the investment and is a cost-effective strategy to improve medication safety.”
When it comes to patients, a CPOE can help them save time and money in at least two ways. First, it will help patients cut back on pharmacy visits for drug orders. Finally, a CPOE prevents a patient from receiving the wrong medication, which protects the patient’s health and avoids costly and time-consuming stays in a hospital.
CPOE Challenges
Like any other technological system, CPOE comes with its own set of challenges. Most of them are associated with implementing the system, which is not as simple as buying a computer program such as Microsoft Office and clicking “enter order.” Below are the most common challenges reported by hospitals worldwide:
- Initial Setup
- Workflow Disruption
- Data Entry
- Cultural Obstacles
Initial Setup
Setting up CPOE can take an enormous amount of time and money. Rural and urban hospitals spent between $1.3 million to $11 million to implement the system. It's not always easy to integrate CPOE hardware and software with existing systems in an institution. Even off-the-shelf solutions cost a lot of money to customize for each healthcare provider, whether it is a hospital, clinic, or laboratory. To make a CPOE system effective and efficient, you must integrate into an institution's other systems such as EMR's, laboratory information management systems (LIMS), or pharmacy software solutions. As discussed above, however, CPOE is cost-effective in the long run.
Workflow Disruption
One of the biggest challenges in implementing CPOE is that it can disrupt workflow to a degree for a couple of reasons. The first one is training. The medical staff, including doctors, nurses, and pharmacists, must learn how to use the system. They must have basic computer skills. Change can be uncomfortable for the older staff, who have been working with the old system for a long time. As time goes on and everyone gets used to these changes, there will be less disruption in staff's daily routine.
Data Entry
Another challenge is data entry, which includes typing up orders and getting them entered into the computer system accurately and swiftly without mistakes. Learning this process can be challenging for providers who are used to dictating their orders over phone lines with transcriptionists who then type out the doctor's words all day long. But once people get comfortable using this new technology, it should allow them to type up orders faster.
Cultural Obstacles
A significant barrier to using the system has been ensuring the staff is comfortable using new technology. This has reportedly been a challenge at some establishments where physicians have resisted using CPOE tools due to cultural reasons such as relying on their own experience. Some physicians want to maintain their long history of dictating and using paper charts, and those traditionally trained in an environment where they used pen and paper instead of keyboards. Another concern of physicians is that patients will be less satisfied with mechanical ordering, lack of eye contact, or nonverbal cues, a claim that remains unsubstantiated mainly.
Summary
To sum up, despite challenges with implementing CPOE, hospitals that have adopted the technology report a reduction in medication errors, saving lives and money. The system is designed for hospitals and physician offices to manage the ordering of prescriptions, tests, treatments, and other medical orders that could be fatal if administered incorrectly. CPOE will streamline hospital workflow while improving patient safety by reducing human error in prescription writing and preventing unnecessary deaths.
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