Ji Sun Sally Kim IWA #4
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Harrisburg University of Science and Technology *
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500
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Health Science
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Dec 6, 2023
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Uploaded by JudgeEchidnaMaster1024
Assignment #4
Ji Sun “Sally” Kim
Harrisburg University of Science and Technology
HCIN 500-50 A
Dr. Steven Hardy
September 19, 2023
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Assignment #4
Reasons for Using CPOE
Computerized Patient Order Entry or CPOE is a feature in electronic health records that
“processes orders for medications, lab tests, imaging, consults, and other diagnostic tests” (Hoyt
& Mohan, 2018, p. 221). While the effectiveness of the benefits provided by CPOE has been
debated amongst various literature, there are several potential benefits for institutions to utilize
CPOE. First, CPOE has the potential to reduce medical errors. Paper records can be illegible due
to the poor handwriting of the physician and lost especially during natural disasters, and
accordingly transcribing, retrieving, and transferring these records for future usage can be
difficult and expensive (Kazley & Ozcan, 2008). Not being able to create a holistic record for
patients that can follow them wherever they choose to seek medical services can create a
“fragmentation of care,” which can result in errors in the form of duplicate, missing, or
inaccurate medical services (Kazley & Ozcan, 2008). CPOE also allows multiple clinicians in
the same facility to add digital records to the patient’s charts, which can allow the clinicians to
access and view the real-time updated records, which would decrease the chances of errors
(Kazley & Ozcan, 2008).
Second, CPOE standardizes clinical pathways and procedures. In the 2014 journal about
the Quality, Implementation, and Evaluation Model or QIE Model, the authors point out the
significance policy review plays in the improvement of the quality of healthcare (Talsma et al.,
2014). Having a standardized procedure and guidelines for clinicians can help improve the
quality of the care being provided. An institution with EHR often has to go through extensive
training in order to allow the users to become accustomed to the new paradigm of workflow,
which means that everyone will be on the same page in terms of how to execute tasks (Hoyt &
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Mohan, 2018, p. 226). With forethought, leadership, planning, and training, CPOE will allow for
an optimized policy and guideline laid out for clinicians by having a set workflow and a decision
support algorithm within the system that the users must follow, which can reduce variations in
care (Hoyt & Mohan, 2018, p. 225—226).
Lastly, CPOE can help ensure the safety of patients with alerts, which can in turn reduce
the costs for the healthcare provider. For example, the embedded programs can check for
allergies, ensure the correct drug name is inputted, and alert the user about drug-drug interactions
(Hoyt & Mohan, 2018, p. 221). Inappropriate testing or treatment may also be avoided with the
guidance of CPOE (Kazley & Ozcan, 2008). A meta-analysis of CPOE suggested that
transitioning from paper systems to CPOE systems in ICUs was associated “with an 85%
reduction in medication prescribing error rates” (Hoyt & Mohan, 2018, p 223). While ensuring
patient safety, CPOE can help cut down the costs that come from, for example, under and over-
prescribing, re-filling already filled prescriptions, and performing inappropriate testing (Hoyt &
Mohan, 2018, p. 221). Studies have shown that, compared to paper records, CPOE saved, on
average $887 per admission or between $11.6 million and $170 million per hospital depending
on its size (Hoyt & Mohan, 2018, p. 224—225).
Attributes of EMR
While there are many great attributes to implementing EHR, there are certain attributes
that are more important than others when it comes to each institution choosing which EHR from
the marketplace to utilize, and these vary depending on the size of the practice. For smaller
practices, the ease of use, user-friendliness, and customizability may be of importance as smaller
practices may have more specified needs and do not need cookie-cutter forms and templates that
bigger hospitals with many departments may need (The American Academy of Child and
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Adolescent Psychiatry, 2023). Smaller practices also may have less access to external personnel
that can do excessive training on the users so user friendliness and support from the vendor may
be crucial (The American Academy of Child and Adolescent Psychiatry, 2023). The ability to
communicate information with the patients may also be important as patients are more likely to
visit smaller practices more frequently than larger hospitals, so having an organized way of
communicating information, whether that is diagnostics, testing results, treatment plan, or other
useful information for the patient, that is embedded in the EHR would be very helpful (The
American Academy of Child and Adolescent Psychiatry, 2023).
For large multi-specialty groups or community hospitals, technical characteristics, such
as whether the EHR is available on various interfaces may be an important factor, since
clinicians and nurses often do rounds and they would need to carry a portable device, such a
phone or a tablet PC with the EHR on it to be able to efficiently carry out their tasks while being
able to easily access patient information (The American Academy of Child and Adolescent
Psychiatry, 2023). Since larger practices often have guidelines of practice and workflow already
set, the kind of workflow that the EHR has—which cannot be changed unlike the training the
users receive—may be worth considering to more quickly adapt to the new paradigm and
experience the optimized performance (The American Academy of Child and Adolescent
Psychiatry, 2023).
Lastly, for multi-hospital systems, the security of the data that is being entered and stored
may be one of the most important aspects when it comes to picking a specific EHR (The
American Academy of Child and Adolescent Psychiatry, 2023). However, at the same time,
being able to safely access information entered by other clinicians at other institutions and being
able to communicate with them safely would be another important element to ensure quality
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patient care (The American Academy of Child and Adolescent Psychiatry, 2023). Adherence to
open standards may be another important attribute for multi-hospital systems to take a look at, as
not every single hospital within the system may have the exact same EHR, making the ability for
information to be easily transferred to another system an important factor of consideration (The
American Academy of Child and Adolescent Psychiatry, 2023).
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References
The American Academy of Child and Adolescent Psychiatry. (2023). Choosing an Electronic
Medical Record.
https://www.aacap.org/aacap/clinical_practice_center/Business_of_Practice/Health_Inform
ation_Technology_and_Electronic_Medical_Records/Choosing_an_EMR.aspx
Hoyt, R. E., & Mohan, V. (2018). Electronic Health Records. In Hoyt, R. E., & Hersh, W. R.
(Eds.),
Health Informatics: Practical Guide
(7th ed., pp. 200—226). Lulu.com. Retrieved
September 12, 2023, from https://www.scribd.com/read/485889587/Health-Informatics-
Practical-Guide-Seventh-Edition.
Kazley, A. S., & Ozcan, Y. A. (2008). Do Hospitals With Electronic Medical Records (EMRs)
Provide Higher Quality Care? An Examination of Three Clinical Conditions. Medical Care
Research and Review, 65(4), 496–513. https://doi.org/10.1177/1077558707313437
Talsma, A., McLaughlin, M., Bathish, M., Sirihorachai, R., & Kuttner, R. (2014). The
Quality, Implementation, and Evaluation Model: A Clinical Practice Model for Sustainable
Interventions. Western Journal of Nursing Research, 36(7), 929–946.
https://doi.org/10.1177/0193945914537121
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