Overcoming the CPOE Obstacle to MU
Despite all the uncertainty in this world, sometimes what’s expected to happen, happens.
Consider the findings of a study of 2,475 hospitals that in 2010 were preparing to pursue healthcare IT Meaningful Use (MU) incentive payments. The study, published recently in the Journal of the American Medical Informatics Association (JAMIA), found that computerized physician order entry (CPOE) was the main challenge among hospitals that failed to achieve MU in the first year of the program. Specifically, “hospitals that reported the CPOE MU criterion as a primary challenge were 18 percent less likely to receive a 2011 MU payment compared to hospitals that reported other criteria as primary challenges.”
Why is this result not surprising? Mainly because CPOE is hard to do right – that is, in a way which invites high levels of sustained physician adoption. And CPOE also is hard to do quickly; implementing an electronic order entry system from scratch historically has taken years and millions of dollars. (Chances are the hospitals that felt CPOE would be their greatest challenge were starting from scratch; many hospitals that demonstrated Stage 1 MU in year one of the program did so by leveraging existing ED systems.)
So the study’s recommendation that greater attention be focused on hospitals’ challenges with CPOE makes good sense, especially given the dramatically higher CPOE targets in Stage 2. Nothing will help those hospitals more than CPOE systems that (1) fully support physicians’ workflow; (2) are easy for physicians to use (and to learn); and (3) are relatively fast and easy for IT to implement (e.g., work with hospitals’ existing systems, and don’t break the bank).
While such CPOE systems still are relatively rare, they are currently being installed at a number of community hospitals around the U.S. And with their advent, hospitals’ expectations – along with their physician adoption, and their MU rates – are rising.
Again, sometimes what’s expected to happen, happens.