Pick a CPOE that’s right for your ED and hospital
Run detailed case studies
(Editors’ note: This is the second in a two-part series on computerized physician order entry [CPOE]. In this month’s article, we tell you how to compare different systems, and we cover other key steps in the decision-making process. In last month’s issue, we told you how to plan for such a system.)
If you’re in the market for a CPOE, it’s important to play with a number of systems before making your choice to determine which is most user friendly and which is the best fit for your ED, advises Brian F. Keaton, MD, FACEP, attending physician/emergency medicine informatics director at Summa Health System, Akron, OH, and president-elect of the American College of Emergency Physicians (ACEP).
What’s more, the CPOE system also must be compatible with your hospitalwide system, he says. "The ED is so tightly linked to the enterprise that it’s foolish to do a CPOE program not tightly linked to it," he says. "I can’t imagine there is a hospital that is not looking at CPOE, so you need to be part of that enterprise process."
Think about what such a system does: It gives information to the lab about what studies need to be done, to radiology, and even to ancillary services such as dietary, Keaton says. "Ultimately, the orders you create in the ED have to be translated into their language and become part of the hospital’s electronic record, so you need to be playing in that game," he says.
The big part of searching for the right system "is to sit down and play with it," Keaton suggests. "It’s wonderful to have someone come in and give you a demo."
Use scenarios specific to your ED, employees
Keaton’s staff sat down with its 10 most common patient care scenarios and developed detailed cases that were scripted out. "Then, we’d sit down and go through those cases with each of the systems that came in," he says. First, they would read the case to the manufacturer’s representative and watch how they progressed and how long the process took.
"We would make the manufacturer’s representative do the tasks that were required of their system to accomplish the tasks dictated by the scenario," he explains. "For example, we timed and counted the number of mouse clicks and typing necessary to register a patient, order a [complete blood count], view an X-ray, find an old dictated operative note, and so forth."
There are clear differences in the way manufacturers handle data entry needs, especially with repetitive tasks, notes Keaton. "Another instructive point was watching the restrictions placed on work flow by the system," he says. "For example, were orders batched or executed in the order they were placed?"
Then, the system was tested on someone from the department who was reasonably adept, Keaton recalls. "Next, we took someone who knew nothing, which showed us the beginning of the learning curve. We also had the learning curve for the average person and used the teacher as an example of as good as it could get.’"
If the vendor has a system that would be compatible with the common patient care scenarios and the existing hospital electronics, the vendor should be able to rapidly educate several ED employees on effective use of the system, say emergency medicine sources. They note that using your ED staff to demonstrate the product to the decision makers is much more effective than having the vendor staff perform that task.
As for whether to incorporate an ED module into a hospitalwide system or purchase an all-inclusive ED system, Keaton concedes that it’s very tempting to buy the latter. However, he cautions, it’s still useful to go to ACEP meetings or similar industry gatherings and experiment with the different systems side by side. "Then, you really have to take the vendor you pick, put them together with the enterprise vendor, and make sure the ED system interfaces well with them," he cautions. "Otherwise, it could cost you $20,000 to $30,000 to build an interface."
Source
For more information on computerized order entry, contact:
- Brian F. Keaton, MD, FACEP, Attending Physician/ Emergency Medicine Informatics Director, Summa Health System, 525 E. Market St., Akron, OH 44310. E-mail: [email protected].
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content