Summary
Objective
Authors provide a perspective on factors leading to successful care provider order
entry (CPOE) implementations.
Methods
Viewpoint of authors supported by background literature review.
Results
Authors review both benefits and challenges related to CPOE implementation using three
guiding principles: (1) a clinical approach to clinical systems, which claims that CPOE implementation is analogous to a “good” clinician delivering
care to a patient; (2) a commitment to quality, which advocates that no compromises should be made in implementing system functionality
and clinical system content – the highest objective for CPOE implementation is to
provide better quality of care and increased safety for patients; (3) a commitment to fairness, as evidenced by respect for individuals and support of local
autonomy, which advocates for minimizing disruptions to clinician-users’ workflows, and adequate
local control over CPOE system design and evolution, including clinical content management.
Conclusions
Past experiences with CPOE implementation can inform future installation attempts.
Sociocultural factors dominate in determining the success of implementation, and should
govern technical factors.
Keywords
Medical order entry systems; socioeconomic factors; decision making - organizational;
decision support systems - clinical; practice guidelines; hospital information systems;
physician’s practice patterns