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Entry 3


Q: What key questions should healthcare providers ask?

A: By all accounts, change management is key to a

successful implementation. As the CPOE working group at HIMSS put it: “CPOE projects are more about organization- wide change than IT implementation.” Addressing these changes means answering key questions: • Does the new system operate fast enough for clinicians?

• What effect does it have on communication? • What impact does it have on workflow, and did clinicians understand how it would change their jobs? The integration must be planned carefully, and users

must be ready for it. OHSU researchers recently examined a link between CPOE and clinical decision support and found that many of the factors leading to successful CPOE implementation are related to the CDS component of the systems. When CPOE is used in conjunction with CDS, both costs and errors can be reduced. These findings are consistent with a recent study of CPOE use at Brigham and Women’s Hospital in Boston, where it was found that CPOE was most likely to be used by personnel already using an electronic health record or other clinical application.

Q: Should healthcare organizations roll out a CPOE system


incrementally? HIMSS points out that most organizations to date have gone with an incremental rollout, initially leaving out

some units that have different workflows. The incremental approach can be done by location or by specialty. The latter can be less complicated, since it deals with a limited number of order sets at a time. While an incremental approach may be easier, an all-at-

once approach has the advantages of highlighting to end- users the importance of the new technology, eliminating the need for dual processes and making a clean break from paper-based order entry.

Q: What are the main steps of A:

a CPOE implementation? Implementing CPOE is, by all accounts, no easy task.

Some organizations have taken years to get through it. HIMSS breaks implementation into six stages— initiating, planning, executing, monitoring and controlling, transitioning to operations, and optimization and maintenance. The HIMSS CPOE wiki provides tips for each stage of implementation. For example, executing a CPOE system— that is, designing, building, and preparing for it to go live— involves a dozen steps that cover software installation, training, governance, support, and more. HIMSS also sets out 22 building blocks that it deems fundamental to implementation.

Turn the page to learn about how our Clinical Device Assessment Service can help you get on the right path to implementing CPOE and meaningful use.



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