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Methods Inf Med 2010; 49(01): 20-27
DOI: 10.3414/ME0631
Original Articles
Schattauer GmbH

Computerized Provider Order Entry System – Does it Support the Inter-professional Medication Process?

Lessons from a Dutch Academic Hospital
Z. Niazkhani
1   Institute of Health Policy and Management (iBMG), Erasmus University Medical Center, Rotterdam, The Netherlands
,
H. Pirnejad
1   Institute of Health Policy and Management (iBMG), Erasmus University Medical Center, Rotterdam, The Netherlands
,
H. van der Sijs
2   Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands
,
A. de Bont
1   Institute of Health Policy and Management (iBMG), Erasmus University Medical Center, Rotterdam, The Netherlands
,
J. Aarts
1   Institute of Health Policy and Management (iBMG), Erasmus University Medical Center, Rotterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

received: 17 September 2008

accepted: 23 March 2009

Publication Date:
17 January 2018 (online)

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Summary

Objectives: To assess the effects of a CPOE system on inter-professional workflow in the medication process.

Methods: Twenty-three semi-structured interviews with physicians, nurses, and pharmacists were conducted in a Dutch academic hospital. In addition, the handwritten and system-generated documents used daily were collected for analysis. Data was analyzed on the basis of three conceptual themes in the inter-professional workflow: division of tasks, flow of information, and task coordination.

Results: The CPOE system reorganized the existing work procedures, affecting the work-flow among the three professional groups both advantageously and disadvantageously. The system resulted in the reassignment of tasks and reallocation of areas of expertise in the medication process. Moreover, patients’ medication-related information became fragmented in both the paper records and in the electronic records, as well as in different professional domains. The system provided lim ited support for professional groups to coordinate their tasks temporally. It also made it difficult to build mutual intelligibility upon new changes in the medication plan. To integrate tasks, the professional groups had to bypass the system or add new steps and extra coordinative tasks.

Conclusion: We identified several workflow integration issues after the implementation of a CPOE system. Our insights into these issues can help ensure that the system design or redesign properly integrates all tasks, information, and areas of expertise of professional groups into those of the physicians.

Keywords

Medical order entry systems - computerized physician order entry - clinical workflow - evaluation studies - collaboration - CPOE
 

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