COMPUTERIZED PROVIDER ORDER ENTRY

Presented By,

JYOTIRMOY ROY

B.Phrm.6th sem

BCDA COLLEGE OF PHARMACY AND TECHNOLOGY

OBJECTIVES

1. Describe Computer-Based Provider Order Entry (CPOE)

2. Problems with Manual System

3. Why CPOE ?

4. Available hardware and software for CPOE

5. How CPOE work ?

6. Example of CPOE screen Provider

7. CPOE NETWORK

8. Advantages and disadvantages of CPOE

9. Conclusion

10. References

Computerize provider Oder entry

(CPOE)

Known as Computerized physician order entry (CPOE)

A system that allows providers to place specific order electronically through

the computer.

It's the process of a medical professional entering meditation order or other

physician instructions electronically instead on paper charts .

CPOE system are often used in tandem with e-prescribing system ,which alert

physicians and clinicians to a particular patient's drug allergies and current

medication.

The problem with Manual system

Deciphering hieroglyphics (provider‘s handwriting)

Incomplete or Inappropriate Oder

Order on the wrong patient

Drug/Drug , Drug/Formulary ,Drug-Allergy issues

Delays-workflow

For These Problems

Estimated that between 44,000 to 98,000 hospital deaths/year Due to

medical errors

Two resent Harvard Studies found that physician ordering errors accounted for

56%-78% of all preventable adverse Drug Events.

Why CPOE

Order Communication

Clarity of orders

Ease of Identifying the Ordering Physician

Standardization of care

Clinically validated order sets for

Clinical diagnoses

Procedures

Situations (post-op order sets )

Alerts and Reminders (Real Time Decision Support)

Drug safety Database (Conflict checking)

Clinically validated Rules

CPOE Hardware And Software

Desktop computer

Laptop

Computer on wheels

PDA (Personal Digital Assistant)

PALM Pilot

Provider Order System

Multiple manufacturers

Cerner

McKesson

Eclipsys

Siemens

Quadra med

HMS

Meditech

Working of CPOE

Example 1 of CPOE screen Provider

Example 2 of CPOE screen Provider

CPOE NETWORK

Advantages of CPOE

Ensures that orders are legible

Prevents medication errors which can save money and lives

The Institute of Medicine estimates that the United States spends about $37.6 billion each year for

medical errors,$17 billion of those costs are preventable (McGonigle & Mastrian,2012,P.219)

In 20000 about 98,000 people died as a result of medical errors in the United States (Hoey,Nichol

& Silverman,2009)

Can keeps costs down if the software is used correctly

Improves quality of care

Can save time verify orders

Alerts

Medication expiring ,duplicate order ,contraindications

Will prevent illegal handwritten orders/prescriptions

Provides decision support

Disadvantages

Can cause negative workflow for unit clerks as they may not be able to verify

orders in a timely manner before the order is carried out (Dixon &Zafar,2009)

Needs training which is costly and time consuming (Dixon &Zafar,2009)

Software can be expensive to start and maintain (Hoey,Nichol &

Silverman,2009)

Can change workflow and result in less communication between healthcare

professionals as a result of electronically processed orders ( Hoey, Nichol &

Silverman ,2009)

Unavailable with computer downtime

CONCLUSION

CPOE systems with clinical decision support systems can improve medication

safety and quality of care as well as compliance with guidelines and the

efficiency of hospital workflow; they can also reduce the cost of care.

The unintended consequences of CPOE are widespread and important to those

knowledgeable about CPOE in hospitals. They can be positive, negative, or

both, depending on one’s perspective, and they continue to exist over the

duration of use. Aggressive detection and management of adverse unintended

consequences is vital for CPOE success.

References

1.agency for Healthcare Research and Quality

(2009). http://healthit.ahrq.gov/images/jan09cpoereport/cpoe_issue_paper.htm

2. Institute of Medicine (1999). "To Err Is Human: Building a Safer Health System (1999)". The

National Academies Press.

3. Institute of Medicine (2001). "Crossing the Quality Chasm: A New Health System for the 21st

Century". The National Academies Press..

4.The Institute of Medicine (2006). "Preventing Medication Errors". The National Academies

Press.

5.Oren, E.; Shaffer, E. & Guglielmo, B. (2003). "Impact of emerging technologies on medication

errors and adverse drug events.". American Journal of Health-System Pharmacy. 60: 1447–

1458.

6 David W. Bates, MD; et al. (1998). "Effect of Computerized Physician Order Entry and a Team

Intervention on Prevention of Serious Medication Errors" (abstract). JAMA. 280

7. http://www.eurekalert.org/pub_releases/2010-05/sumc-ssf042710.php.

10.Lohr, Steve (2005-03-09). "Doctors' Journal Says Computing Is No Panacea". The New York

Times. Retrieved 2006-07-15.

THANK YOU