Characteristics of CPOE Systems and Obstacles to Implementation That Physicians Believe Will Affect Adoption
Dushyant Singh, Sue Spiers, Brent W. Beasley
Abstract
Dushyant Singh, Sue Spiers, Brent W. Beasley
Abstract
BACKGROUND: Computerized Physician Order Entry (CPOE) has the potential to decrease medical errors and improve quality. Our health system plans to implement CPOE in response to the ARRA HITECH Act. OBJECTIVES: To determine (A) physicians' projections of the most important characteristics of a CPOE system that will affect their willingness to adopt CPOE, and (B) the obstacles they foresee in adopting CPOE. METHODS: All members of our health system's physician quality organization were invited to participate in a confidential survey. RESULTS: Two hundred twenty-four of 549 (41%) recipients responded to the survey. Respondents ranked "disruption in my work routine" (72%) and "improve efficiency in placing orders" (63%) as the two most important characteristics that would affect their utilization of CPOE. They believed CPOE would enable orders to be placed more efficiently (3.3, sd = 1.2), carried out rapidly (3.4, sd = 0.9), and have fewer errors (3.7, sd = 0.9). The most commonly cited obstacles to CPOE implementation were: Efficiency-Inefficiency (23%), Hardware Availability (12.7%), Computer Restrictions (10.8%), Training (8.8%), Simplicity - Ease of Use (8.5%), and Physician Buy-in (8.1%). CONCLUSIONS: The majority of physicians believed CPOE would lead to a reduction of medical errors and more efficient patient care. However, physicians are highly concerned with how CPOE will affect their own work efficiency.
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BACKGROUND: Computerized Physician Order Entry (CPOE) has the potential to decrease medical errors and improve quality. Our health system plans to implement CPOE in response to the ARRA HITECH Act. OBJECTIVES: To determine (A) physicians' projections of the most important characteristics of a CPOE system that will affect their willingness to adopt CPOE, and (B) the obstacles they foresee in adopting CPOE. METHODS: All members of our health system's physician quality organization were invited to participate in a confidential survey. RESULTS: Two hundred twenty-four of 549 (41%) recipients responded to the survey. Respondents ranked "disruption in my work routine" (72%) and "improve efficiency in placing orders" (63%) as the two most important characteristics that would affect their utilization of CPOE. They believed CPOE would enable orders to be placed more efficiently (3.3, sd = 1.2), carried out rapidly (3.4, sd = 0.9), and have fewer errors (3.7, sd = 0.9). The most commonly cited obstacles to CPOE implementation were: Efficiency-Inefficiency (23%), Hardware Availability (12.7%), Computer Restrictions (10.8%), Training (8.8%), Simplicity - Ease of Use (8.5%), and Physician Buy-in (8.1%). CONCLUSIONS: The majority of physicians believed CPOE would lead to a reduction of medical errors and more efficient patient care. However, physicians are highly concerned with how CPOE will affect their own work efficiency.
Key concepts: Medicine, Computerized physician order entry, Confidentiality, Affect (linguistics), Inefficiency, Health care, Quality (philosophy), Health information technology