Computerized Physician Order Entry (CPOE) system – How it improves efficiency of a Healthcare delivery system

Computerized provider order entry (CPOE) is an application that allows healthcare providers to directly enter medical orders electronically. CPOE systems can allow electronic entry of medication, laboratory, admission, radiology, referral, and procedure orders.

Developing and implementing CPOE is multidisciplinary effort and involves IT, clinical, business and informatics expertise with the following goals in mind:

• Reducing the potential for human error.
• Reducing time to care delivery.
• Improving order accuracy.
• Decreasing time for order confirmation and turnaround.
• Improving clinical decision support at the point of care.
• Making crucial information more readily available.
• Improving communication among physicians, ancillary staff and patients.

CPOE has tremendous benefits that impact overall efficiency of the healthcare delivery system. It enables safer, more consistent patient-centered care that is quantifiable. Time efficiency is a huge benefit of implementing CPOE across an organization. CPOE users find improved efficiency to be even more impactful than its technological advances. Specifically, with enhanced time efficiency, clinicians can communicate more effectively, provide care more accurately, and focus more of their time on patients’ needs. These benefits include:

• Legible order entry: This allows for a decreased risk of duplicative, incorrect or erroneous orders.
• Protocol adherence: Various kinds of checks for each order allows for a system to ensure adequate patient preparation and protocol adherence. This, in turn, ensures optimal management practices.
• Clinical Decision Support system: Various CDS models can be added to the EHR-CPOE systems to allow useful information, including guidelines recommendations, checks, suggestions for suitable management steps based on the available information on the patient condition.
• Medication-related checks: These include medication reconciliation that checks for duplicative medications, drug-drug interactions, allergies, medication contraindications, and renal- and weight-based dosing.

Specifically, CPOE minimizes or altogether eliminates:

• The need to maintain physical patients’ charts.
• Overlooked orders by nurses or unit secretaries.
• The need for order clarification due to illegibility.
• The need to manually reenter data, leading to transcription errors.
• Override rates from electronic drug dispensing systems.

Successful CPOE implementation depends on high level of leadership involvement, widespread commitment to the project, availability of resources, access to technology, and comprehensive training and communication. When these ingredients are present to implement CPOE across the organization, it has a tremendous impact.

Health delivery centers continue to strive to improve patient safety and quality of care. There is also an increased focus on the efficiency of health care. The Joint Commission defined the important dimensions of performance for quality of care as “patient perspective issues; safety of the care environment; and accessibility, appropriateness, continuity, effectiveness, efficacy, efficiency, and timeliness of care.”

Overall, CPOE systems with CDS can improve medication safety, quality of care, compliance with guidelines and protocols, while reducing medical errors and spurious healthcare dollar spending at the same time, the cost of healthcare.