Is CPOE Getting Better–or Just Bigger?
Like Tom Hanks’ character in a popular 1980s comedy movie, computerized physician order entry (CPOE) software seems suddenly to have gotten “big”; but whether it has “matured” is an open question.
Arguably CPOE is bigger (more installations, more users) than it used to be, in terms of the technology’s presence within hospitals. But is CPOE really any better today than it was during all those decades it spent in the healthcare IT wilderness?
The question is not academic. If hospitals are to reach and surpass the proposed Stage 2 Meaningful Use threshold for CPOE usage – 60 percent of all medication, lab and radiology orders – it’s going to require a lot of physicians, doing a lot of electronic order entry, for a lot of patients. And the only way that many physicians will play CPOE ball is if the software saves them time and is really easy to use. Specifically, that means:
• Don’t force physicians to change how they practice medicine to accommodate the design of the software;
• Give physicians the flexibility to place orders on their smartphones and tablets, in addition to computers; and
• Implement CPOE that can work with existing hospital systems, so physicians don’t have to wait (perhaps years) for completion of a massive hospital IT overhaul to begin entering orders electronically.
Unfortunately, not many CPOE systems meet these criteria for physician ease-of-use – which gets back to the question of whether today’s CPOE software is significantly better than what physicians rejected in the past. Until it is, CPOE may continue its slow crawl up the adoption curve, but it is unlikely to garner a level of physician adoption beyond the Stage 2 minimum. While 60 percent is far better than 30 percent, neither represents the sustained, high level of physician adoption that ultimately will yield the efficient clinical workflow, improved patient safety and decreased costs that have long been the promise of CPOE.
In other words, “big” isn’t all it’s cracked up to be without some maturity to go along with it.
[This post was adapted from a commentary by Dr. Burt published in the August 2012 edition of Healthcare IT News.]