Tuesday, May 18, 2010
BIDMC implemented Computerized Provider Order Entry in 2001. As we approach the ten year anniversary of our implementation, it's great to see the recent press on the Stanford study demonstrating a 20% decrease in mortality after implementing CPOE at Lucile Packard Children’s Hospital.
I've written about our experience and my top 10 approaches to make CPOE successful.
Our CEO has blogged about it.
Medscape has a great summary of the effort.
The bottom line - of course bad software implemented poorly can cause new errors. Of course change in workflow can cause unintended consequences.
However, now that the industry has broad experience with electronic ordering (it's a meaningful use requirement for 2011), I think we can conclude that questioning the wisdom of implementing CPOE is like asking if a parachute works against gravity - I do not want to be in the control group of that clinical trial!
We need to be careful to design clinician friendly user interfaces, embrace web-based systems that require little training, and incorporate enough decision support to keep patients safe but careful to avoid crying wolf too often, creating alert fatigue.
As I wrote in a recent blog, paper-based medication ordering killed my grandmother. Unreadable orders, drug-drug interactions, and prescribing errors in the elderly cause harm.
The Stanford study now gives us the objective evidence we've been waiting for. We can use CPOE with confidence and finish the implementation in those community hospitals which do not yet have it.
CPOE is the medication version of a parachute. I would not want to write medications without CPOE any more than I would want to jump from a plane without a parachute.
Posted by John Halamka at 3:00 AM