Implementation of Computerized Physician Order Entry

Introduction

Electronic medical records system entails computerization of storage, retrieval, and modification of clinical or medical information by the medical care providers. Medical information is an essential component to the organizations providing medical care to the patients such as hospitals and clinics (Santell, 2004, p. 24). Computerization of the information storage and retrieval facilitates service delivery in these organizations as storage and speed of retrieval of the information are improved significantly. Although this method of data storage encourages the use and application of the new technology, many doctors in hospitals still prefer using paper records due to the low cost and ease of data entry. However, paper-based medical records bear overwhelming disadvantages over the advantages especially depending on the bulkiness of the documents and the availability of space for storage and difficulty in retrieval (Saba, & McCormick, 2005, p.334). Computerization increases the efficiency of service delivery in these institutions as the bulkiness of the data and limited storage space problems are solved.

Computerized physician order entry system

This system is one of the many electronic medical records systems, which involve the submission of a doctor’s instructions or orders for the treatment of patients under his/her care. Transmission of the instructions and orders occurs via the computer network to medical staff or involved departments; for instance, the pharmacy and nurses departments that implement the orders given (Joos, 2009, p.55). This system possesses a lot of advantages to both the patient and the health providers such as reducing delay in giving medical attention, checking errors that could result from handwritten instructions, and allowing doctors to give instructions even when away or within the health providing institution among others (Downing, 2007, p.123). Implementation of this system eliminates detrimental errors involving dosage and diagnostic errors, which can harm or cause death to the patients. On the other hand, this system has also some disadvantages especially on the usage of the new technology calling for further training on the usage and applicability of the programs involved. Inexperience can cause delays in the retrieval of the information affecting the time taken in the execution of the orders.

Implementation

The adoption of the Computerized Physician Order Entry System (CPOE) meets resistance and opposition not only on the expensive training involved, but also from the rigid doctors who believe paper documentation is the easiest. Even with compelling proof that implementation of this system in medical fields will reduce mortalities out of errors by great percentage, some doctors oppose this worth change and continue to stick to their old medical practices (Demetriades, 2003, p. 223). Adoption of this technology cuts down the cost of storage of the paper records leading to high-profit margin realization annually for the healthcare institutions. The provision of quality health care also depends on the usage of this technology.

Nevertheless, given the high financial gain accompanying the use of the CPOE, many doctors gradually continue to welcome the technology causing restructuring in the management and recruitment to absorb personnel with computer knowledge. The acceptance of the technology initiates the implementation process with the many that support the technology overriding the few who resist the idea (Yoder-Wise, 2001, p.111). Although the cost of implementation and maintenance of the technology remains high, the outcomes of the implementation are higher either. According to McGonigle, & Mastrain, in Massachusetts, patients in a community hospital suffered a medication error, which was preventable through the application of CPOE. A report from the Massachusetts hospital showed that complete implementation of the CPOE could help control over 55,000 cases of adverse medical errors caused out of written descriptions (2008, p.226). The findings propelled the commonwealth of Massachusetts to pass laws of ensuring all hospitals implement the use of CPEO and this was part of licensing conditions for operations.

In the United States, despite the gains of the CPEO, many hospitals have not implemented the technology. According to Rick, about 10% of the hospitals in the U.S had not implemented the CPEO by 2006 and about 34% of the private doctors partially used CPEO (2006, p.86). This represents a low rate of implementation with many doctors sticking to the old medical procedures and not allowing change.

Conclusion

Technological adoption in the health-providing sectors not only sets in numerous advantages such as timely delivery of life-saving medical services but also sets in some disadvantages. The disadvantages accruing from the implementation of the CPEO in health-providing organizations include the high costs of implementation and maintenance of the technology, training for affective application and usage and even restricting of the existing systems and procedures in these organizations to allow the new technology. These limitations prevent quick and effective implementation of the CPEO and therefore, few hospitals, which comply and allow the technology, do enjoy the benefits of CPEO. Such benefits include quick and accurate delivery of services regardless of the doctors’ proximity, saving on space and money used in paper-based records, and reduction in medication errors caused through handwritten prescriptions.

Reference List

Demetriades, J. (2003). Person-centered health records. New York: New York press.

Downing, S. (2007). On course. New York: McGraw- Hill.

Joos, I. (2009). Introduction to computers on healthcare professional. New York: Macmillan.

McGonigle, D., & Mastrain, K. (2008). Nursing informatics: A foundation of knowledge. USA: Jones& Bartlett publisher.

Rick, D. (2006). Nursing fundamentals. Westport, CT: Greenwood.

Saba, V., & McCormick, K. (2005). Essentials of nursing informatics. New York: McGraw-Hill.

Santell, J. (2004). Computer related errors. USA: Washington post press.

Yoder-Wise, R. N. (2001). Leading and managing in nursing. USA: American Psychological Association.

Annotated Bibliography

Demetriades, J. (2003). Person-centered health records. New York: New York press.

The author provides learning on how computers and technology affect the nurses’ role in caring for the patient. Patient safety is emphasized with a focus on privacy issues and decision support tools. Computer utilization in the health sector is provided on a chapter basis with a chapter introductory section comprehensively giving an overview of the contents. It describes the national health information integration with technology. It includes articulation of the information technology to the large data collected nationally. More focus is on the personal presentation of the information. The book also compares effective service delivery in computer-applied cases and manual cases and finally it focuses on the benefits of technology.

Downing, S. (2007). On course. New York: McGraw- Hill

The book provides clear guidance and guidelines on the application of computer programs in dealing with large data. It describes proper usage of grammar as a communication tool in health-providing organizations. It emphasizes the applicability of computers in health provision services to health professionals. The author explores a hands-on approach to learning essential life and study skills. It covers extensively the study skills including reading, note-taking, memory, and test-taking. It also involves computer study skills offering practical computer studies for experience in computer usage. In addition, it emphasizes the study skills on life issues linking them with technology advancement.

Joos, I. (2009). Introduction to computers on healthcare professional. New York: Macmillan.

Joos gives information in healthcare and computer application in healthcare services coupled with examples in critical thinking on the application of computers in health services. This invaluable book provides rich web resources for healthcare professionals in advanced formats. It gives an introductory overview of computer literacy texts for nurses and other healthcare providers. The book explains the hardware, other popular software programs, operating systems, and computer-assisted communication. Emphasis is put on the application of computer software in healthcare and health-providing services. It introduces the applicability of computers to all fields in a healthcare facility.

McGonigle, D., & Mastrain, K. (2008). Nursing informatics: A foundation of knowledge. USA: Jones& Bartlett publisher.

The book covers the history of healthcare informatics including the applicability of computers in health matters and the advantages accruing as well as the limitations encountered due to implementations. Focuses on the current issues in the health sector, covers basic informatics concepts and management in health organizations. This masterpiece contains introductory parts in each chapter giving comprehensive information on core science information. It provides nursing informatics to the nurses and healthcare professionals. It also covers the benefits of computer applications in health care facilities and organizations. This book gives information and critical texts on computer applications to nurses giving learning examples coupled with computer study skills.

Rick, D. (2006). Nursing fundamentals. Westport, CT: Greenwood.

This book describes the role of nursing minimum data and effective minimum data management by the nurses. It further provides a comprehensive description of the fundamentals of nurses as medical practitioners with an emphasis on computer application skills. The book mainly focuses on the American nurses association. It offers a fresh balanced perspective look at nursing within a functional health pattern framework. The book makes the complex discipline of nursing with an ever-changing and dynamic nature understandable. It also includes topics such as the impacts of technology on healthcare facilities. It emphasizes wellness, evidence-based practice, and the expansion of health care into the home and community setting

Saba, V., & McCormick, K. (2005). Essentials of nursing informatics. New York: McGraw-Hill.

This book describes computer systems, data standards, and nursing informatics theory. It focuses on upgrading clinical informatics and information systems to improve the information systems for the quick delivery of services. It provides large database discovery procedures and describes practical computer applications. This book offers theoretical background for understanding informatics, which serves many aspects of the profession. The book entails nursing informatics also giving practical help in unlocking computing benefits both now and in future no matter what area of study or specialization. Importantly, it gives the latest information on the effects of the health insurance portability and accountability act guideline.

Santell, J. (2004). Computer related errors. USA: Washington post press.

The author describes errors to medical services caused by computer applications and gives appropriate solutions to specific errors. The book compares errors related to computers and errors related to handwritten reports, prescriptions, orders, and instructions. Santell provides comprehensive introductory part of every chapter denoting the errors addressed in a particular chapter. The book gives a step-by-step clinical procedure with total coverage of the nursing processes. The author opens each chapter with a discussion of the nursing process and practices. Moreover, the book gives comprehensive content related to computer errors in computer operations and applications. It covers the benefits of computer usage in healthcare institutions.

Yoder-Wise, RN. (2001). Leading and managing in nursing. USA: American Psychological Association.

The book explores the controversies including those in the healthcare policy, healthcare privacy, confidentiality, and healthcare security. It also focuses on computing tools in the administration and management of healthcare institutions. It describes the learning and extension of the power and reach of research with computers. This book emphasizes the usage of computer technology in healthcare facilities and organizations. It provides clinical decision-making, delegation, prioritization, and clinical skills. It also entails nursing informatics and gives practical help to the management of many healthcare institutions. It includes chapters involving the impacts of using computers in healthcare institutions. Also provides latest information on the current technology and applicability in the health sector.

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