TY - JOUR
T1 - Extending the understanding of computerized physician order entry
T2 - Implications for professional collaboration, workflow and quality of care
AU - Aarts, Jos
AU - Ash, Joan
AU - Berg, Marc
N1 - Funding Information:
The first author was supported by travel grant R96-223 of The Netherlands Organization for Scientific Research (NWO) and a grant of Erasmus University Rotterdam Trust Fund. As a visiting scientist the first author acknowledges the hospitality of the Department of Medical Informatics and Clinical Epidemiology of the Oregon Health & Science University in Portland, OR. The larger effort is supported by National Library of Medicine grant LM06942. The authors would especially like to thank the interviewees for their participation in this study.
PY - 2007/6
Y1 - 2007/6
N2 - Objective: To describe the perceived effect of computerized physician order entry (CPOE) on professional collaboration, workflow and quality of care. Design: Semi-structured interviews with experts involved in the design, implementation and evaluation of computerized physician order systems in the United States. Measurements: The interview transcripts were analyzed using six key concepts that identify context, professional collaboration, workflow and quality of care. Results: The interviews reveal the complexity of CPOE. Although providers enter the orders, others collaborate in the decision-making process. There is a profound impact on workflow beyond that of the provider. While quality of care is the main impetus for implementation, it remains terribly difficult to measure the impact on quality. Conclusions: A proper understanding of CPOE as a collaborative effort and the transformation of the health care activities into integrated care programs requires an understanding of how orders are created and processed, how CPOE as part of an integrated system can support the workflow, and how risks affecting patient care can be identified and reduced, especially during hand-offs in the workflow.
AB - Objective: To describe the perceived effect of computerized physician order entry (CPOE) on professional collaboration, workflow and quality of care. Design: Semi-structured interviews with experts involved in the design, implementation and evaluation of computerized physician order systems in the United States. Measurements: The interview transcripts were analyzed using six key concepts that identify context, professional collaboration, workflow and quality of care. Results: The interviews reveal the complexity of CPOE. Although providers enter the orders, others collaborate in the decision-making process. There is a profound impact on workflow beyond that of the provider. While quality of care is the main impetus for implementation, it remains terribly difficult to measure the impact on quality. Conclusions: A proper understanding of CPOE as a collaborative effort and the transformation of the health care activities into integrated care programs requires an understanding of how orders are created and processed, how CPOE as part of an integrated system can support the workflow, and how risks affecting patient care can be identified and reduced, especially during hand-offs in the workflow.
KW - Computerized
KW - Computerized physician order entry
KW - Hospital information systems
KW - Medical records systems
KW - Online systems
KW - Qualitative research
KW - Quality of care
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U2 - 10.1016/j.ijmedinf.2006.05.009
DO - 10.1016/j.ijmedinf.2006.05.009
M3 - Article
C2 - 16798068
AN - SCOPUS:34247179685
SN - 1386-5056
VL - 76
SP - S4-S13
JO - International Journal of Medical Informatics
JF - International Journal of Medical Informatics
IS - SUPPL. 1
ER -