ARRA has allocated $20 billion to stimulate the adoption of health IT over the next several years. The largest share of the funding will be for incentive payments through CMS to encourage providers and hospitals to implement health IT systems that demonstrate meaningful use that includes the implementation of CPOE systems. Unfortunately, few tools exist to provide informatics specialists best p...

In the United States, the Centers for Medicare & Medicaid Services (CMS) has begun instituting pay-for-performance incentives that reward hospitals based on patient-centric outcomes such as patient satisfaction. Further, to promote the “meaningful use” of health information technology (HIT), CMS has been prompting hospitals to adopt and use HITs. Computerized Provider Order Entry (CPOE) is one ...

What Is Computerized Physician Order Entry? The Institute of Medicine's (IOM) report on errors in the healthcare delivery system, To Err is Human, was first published in 1999. 1 The second IOM report, Crossing the Quality Chasm, published in 2001, provided strategic direction to recreate the U.S. healthcare delivery system to make it safe, effective, patient-centered, timely , efficient, and eq...

simple prescribing decision can initiate unforeseen outcomes. The case described in Box 1 exemplifies how a cascade of unintended events can end in the development of a serious adverse drug event and in the elimination from a patient's medication regimen of a therapy that could have been beneficial if used safely. Evidence obtained in the acute care hospital sector 1 suggests that drug safety c...

U.S. hospitals are under continual pressure both to increase productivity and to improve quality through the use of Health Information Technology. This paper analyzes 3,187 US hospitals, using data reported to the American Hospital Association, to assess changes in productivity over a fiveyear period (2002-2006). The Malmquist Indices derived indicate that Total Factor Productivity (TFP) and Ef...

While it is widely written that advanced clinical information systems can help healthcare organizations reduce adverse medical events and increase patient safety, Alamance Regional Medical Center (ARMC) has proven that it truly does. ARMC chose Eclipsys’ Sunrise Clinical Manager for its ability to provide knowledge-based clinical decision support and its alert capabilities at the time of order ...

Physician-centered design for computerized physician order entry (CPOE) systems overlooks the collaborative, multi-professional nature of medical work. We analyzed the compatibility of the conceptual model of inter-professional workflow underlying a CPOE system with real-life workflow in the medication ordering and administration process. We conducted twenty-three semi-structured interviews wit...

BACKGROUND Implementation delays are common in health information technology (HIT) projects. In this paper, we sought to explore the reasons for delays in implementing major hospital-based HIT, through studying computerized physician order entry (CPOE) and clinical decision support (CDS) systems for prescribing and to develop a provisional taxonomy of causes of implementation delays. METHODS ...

OBJECTIVE To determine the impact of the introduction of new pre-written orders for antimicrobials in a computerized provider order entry (CPOE) system on 1) accuracy of documented indications for antimicrobials in the CPOE system, 2) appropriateness of antimicrobial prescribing, and 3) compliance with the hospital's antimicrobial policy. Prescriber opinions of the new decision support were als...

BACKGROUND Computerized Provider Order Entry (CPOE) and Clinical Decision Support System (CDSS) help practitioners to choose evidence-based decisions, regarding patients' needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet. OBJECTIVE We aimed to evaluate the impact of a CDSS to improve the us...