Computerized provider order entry adoption: Implications for clinical workflow

Emily M. Campbell, Kenneth P. Guappone, Dean F. Sittig, Richard H. Dykstra, Joan S. Ash

Research output: Contribution to journalArticle

96 Scopus citations

Abstract

OBJECTIVE: To identify and describe unintended adverse consequences related to clinical workflow when implementing or using computerized provider order entry (CPOE) systems. METHODS: We analyzed qualitative data from field observations and formal interviews gathered over a three-year period at five hospitals in three organizations. Five multidisciplinary researchers worked together to identify themes related to the impacts of CPOE systems on clinical workflow. RESULTS: CPOE systems can affect clinical work by 1) introducing or exposing human/computer interaction problems, 2) altering the pace, sequencing, and dynamics of clinical activities, 3) providing only partial support for the work activities of all types of clinical personnel, 4) reducing clinical situation awareness, and 5) poorly reflecting organizational policy and procedure. CONCLUSIONS: As CPOE systems evolve, those involved must take care to mitigate the many unintended adverse effects these systems have on clinical workflow. Workflow issues resulting from CPOE can be mitigated by iteratively altering both clinical workflow and the CPOE system until a satisfactory fit is achieved.

Original languageEnglish (US)
Pages (from-to)21-26
Number of pages6
JournalJournal of general internal medicine
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2009

Keywords

  • Attitude to computers
  • Hospital information systems
  • Physician order entry
  • User-computer interface

ASJC Scopus subject areas

  • Internal Medicine

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