e-Prescriptions Can Work, Consultants ContendBy Stacy Lawrence | Posted 04-11-2005
But now, given the negative conclusions of the Journal of American Medicine study, hospitals may be questioning their implementation of CPOE (computer physician order entry) systems.
According to health IT consultancy Capgemini, last year more than one-fifth of hospitals already had CPOE systems in place. And about half of hospital IT executives surveyed in a recent HIMSS (Healthcare Information and Management Systems Society) study cited CPOE systems as among the most important applications for them to implement within the next two years.
In order to encourage the appropriate usage and continued adoption of CPOE systems, Capgemini recently responded to the JAMA study with a series of recommendations for making CPOE systems less likely to be a potential source of patient harm and more likely to fulfill a useful purpose.
According to this analysis, CPOE problems observed in the JAMA study fall into two categories: "information errors that occurred due to data fragmentation and failure to integrate the hospital's information systems and errors that occurred because the CPOE system did not correspond to the work flow or the physician's behavior."
Capgemini argues for seeing "the findings of this study as an indicator for caution and care during systems implementation, rather than an indictment of clinical information technology."
Not only is careful implementation crucial, but keeping physicians and other health care practitioners involved in creating and rolling out the system is a must.
"Establishing the involvement and buy-in of physicians, nurses, pharmacists and radiologists is critical to the success of any clinical system," notes Manuel Lowenhaupt, vice president of Capgemini's clinical transformation practice.
"They need to understand what's in it for themhow the technology can help them make better clinical decisions, work more productively and reduce the time they spend on administrative matters."
Another Capgemini observation is that simply using technology to automate existing practices, which already may be inefficient or unsafe, will continue to result in errors.
If there are problems with the ways physicians are prescribing, these need to be addressed before CPOE systems are just layered on to the problem.
In order to ensure that CPOE systems are performing up to expectations, the health IT consultancy recommends continuous measurement of three areas: patient outcomes, operational improvement and user satisfaction.