Computerized physician order entry, an advanced form of clinical information technology aimed at reducing medical errors, is making slow but measurable headway toward gaining physician acceptance and improving medical outcomes at community hospitals, a new report says.
In a study published today, the Oakland-based California Health Care Foundation and healthcare research firm First Consulting Group, Long Beach, Calif., studied habits and policies at 10 community hospitals and found that each was gradually working toward universal adoption by making the case through the professional culture of the institution that CPOE is "the right thing to do," rather than mandating usage.
According to the survey, a successful CPOE program must have physicians in positions of leadership, direct linkage to clinical improvement and the active involvement of nursing, pharmacy, laboratory and other departments. Typical of the facilities studied was the presence of a physician advisory group to recommend policy, a physician executive who could influence the medical staff and a physician champion to act as liaison between other practitioners and the IT department, the report says.
"Many CPOE project leaders cautioned against using the term mandate at all. Instead they recommended working toward a hospital-wide policy for universal CPOE," the report says.
Each of the hospitals surveyed recommends a gradual rollout of the technology to avoid situations like that at Cedars-Sinai Health System in Los Angeles. Physicians revolted against Cedars in February because a mandatory CPOE system proved to be not quite ready for prime time.
The two research organizations studied habits and policies at 10 community hospitals in Pennsylvania, North Carolina, New Jersey, Maine, Hawaii and Florida and interviewed CPOE specialists from technology vendors Eclipsys Technologies Corp., IDX Systems Corp., Meditech, Per-Se Technologies and Siemens Medical Solutions Health Services Corp.
Community hospitals, which represent 89% of all U.S. acute care facilities, have lagged behind academic institutions because they generally do not employ practicing physicians, nor do they have residents.
"This more independent relationship to the hospital adds to the challenge of bringing physicians on board with CPOE and providing the necessary training to make it successful," according to the report.