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Yearb Med Inform 2007; 16(01): 128-137
DOI: 10.1055/s-0038-1638536
Reviews
Georg Thieme Verlag KG Stuttgart

Care Provider Order Entry (CPOE): A Perspective on Factors Leading to Success or to Failure

A. Ozdas
1   Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
,
R. A. Miller
1   Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
› Author AffiliationsThe authors would like to thank Antoine Geissbuhler, William Stead, Doug Talbert, Russ Waitman, and many others for their substantial contributions to Vanderbilt’s CPOE system. Dr. Miller’s work has been supported in part by a grant from the U.S. National Library of Medicine, R01-LM-007995.
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Publication History

Publication Date:
05 March 2018 (online)

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Summary

Objective

Authors provide a perspective on factors leading to successful care provider order entry (CPOE) implementations.

Methods

Viewpoint of authors supported by background literature review.

Results

Authors review both benefits and challenges related to CPOE implementation using three guiding principles: (1) a clinical approach to clinical systems, which claims that CPOE implementation is analogous to a “good” clinician delivering care to a patient; (2) a commitment to quality, which advocates that no compromises should be made in implementing system functionality and clinical system content – the highest objective for CPOE implementation is to provide better quality of care and increased safety for patients; (3) a commitment to fairness, as evidenced by respect for individuals and support of local autonomy, which advocates for minimizing disruptions to clinician-users’ workflows, and adequate local control over CPOE system design and evolution, including clinical content management.

Conclusions

Past experiences with CPOE implementation can inform future installation attempts. Sociocultural factors dominate in determining the success of implementation, and should govern technical factors.

Keywords

Medical order entry systems; socioeconomic factors; decision making - organizational; decision support systems - clinical; practice guidelines; hospital information systems; physician’s practice patterns
 

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