Let’s Make CPOE Mobile
As a pediatrician who has used CPOE software, I appreciate both the day-to-day difficulties and the great advantages of this technology. And I firmly believe that the healthcare industry will never realize the potential advantages if we don’t first resolve the difficulties, which fall into two general categories: physician unfriendliness, and lack of access.
Making CPOE software more “physician friendly” has many aspects – it must support physician workflow, have an intuitive user interface, and offer flexible order sets and adjustable alerts. But making CPOE more accessible boils down to one thing: put it in physicians’ hands anytime, anywhere. And that means offering CPOE on smartphones and tablets.
At the HIMSS11 conference in Orlando earlier this year, HIT industry analyst John Moore predicted 100 percent physician adoption of smartphones and tablets by 2014. Hospitals, therefore, must enable “physician mobility” through hospital information systems and related applications. After all, handheld devices are of limited utility if they don’t have access to critical patient information.
Why “mobilize” CPOE specifically? There are a few obvious scenarios (and advantages) that leap to mind:
* To eliminate “verbal orders” – I’ve issued my share of verbal orders over my years of medical practice; it’s a common workflow (and problem) at virtually every hospital. But verbal orders have presented a difficult challenge for physicians, nurses, and Medical Records departments alike. Verbal orders are utilized in an attempt to save physicians (and other healthcare providers) time, and to provide necessary patient care when a physician is away from the patient’s bedside and their patient requires new orders. But in practice, verbal orders often take more time for the physician to complete than hand-written orders. So what originally was intended as a “work around” to ensure speedy and effective patient care – and to make things more convenient for physicians – ends up creating additional administrative work for physicians, negatively impacting their workflow and satisfaction, and sometimes putting patient safety at risk. A mobile CPOE solution – one that can be configured with a menu of common medication, laboratory, radiologic and dietary orders, to enable physicians to quickly enter an order that is routed instantly to a printer at the nurse’s station, producing an electronically signed, written order for the nurse or ward clerk to fulfill – would therefore be a solution to multiple problems.
* To improve rounding efficiency – With mobile CPOE, physicians who round throughout one or several hospitals would be able to place orders on the fly, making lab and test results available for discussion with a patient when the physician visits them later in the day, or expediting a discharge that afternoon. Physician (especially hospitalist) productivity and efficiency could be maximized and patient care enhanced by speeding the order entry process.
* To extend the “reach” of existing CPOE systems – Many hospitals that already have deployed CPOE systems are struggling with physician adoption. One reason is they typically require doctors to interact with the CPOE system from a fixed workstation. By adding mobile device support to these systems, hospitals could dramatically increase physician usage and satisfaction by enabling them to place orders directly from the point of care or at their convenience, wherever they may be.
For these reasons and more, mobile CPOE could well emerge as the physician’s “killer app” for iPhones, iPads and other mobile devices. I’m a big fan (and avid user) of handheld devices, so personally, I can’t wait!