Information Technology Applications

Information Technology Applications



Introduction

The wide spread use of EMR has affected our lives in a positive manner. With the implementation of these technological innovations, there has been a tremendous ease in the field of health care and its management system. An EMR system implementation would significantly reduce clinician workload and medical errors while saving the US healthcare system's major expense. Yet, compared to other developed nations, the US lags behind. Before any further elaboration we examine EMR system efforts, benefits, and barriers, as well as steps needed to move the US closer to a nationwide EMR system. The analysis includes a blueprint for implementation of EMR, industry comparisons to highlight the differences between successful and non-successful EMR ventures, references to costs and benefit information, and identification of root causes. The system provides insight into how to systematically overcome challenges. Implementation will require upfront costs including patient privacy that must be addressed early in the development process. Government structure, incentives and mandates are required for nationwide EMR system in the US.

CPOE (Computerized Provider Order Entry), is the direct entering of orders into a computer (or mobile device), so that the order is documented in a digital, structured, and computable format.

Meaningful Use Core Measure: CPOE

The usefulness of CPOE can be observed from the fact that patients with the same medications can have their order entered by the use of CPOE. Exclusion: providers who write fewer than 100 prescriptions during the reporting period. CPOE is one of the measures that elicited quite an animated response from the provider community. (Cross, 2009)

At the initial level, this measure requires 80% of all orders to be directly entered by the provider. To overcome objections to the scope of the requirement and the burden it would impose, CMS ultimately limited the measure to medication orders and reduced the threshold to 30%. (The proposal for Stage 2 reinstitutes lab and radiology orders, but the requirements have not yet been finalized.) There was also a great deal of conversation about who has to enter the order into the EHR—does it have to be the authorizing physician him/herself? This is the only measure in the Final Rule in which CMS addresses who can perform the function, identifying any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. While some providers are unsure about where these specific guidelines can be found, CMS does provide further guidance, stating that CPOE should be done by someone who can exercise clinical judgment and take action based on the alerts and/or clinical decision support information that the order might generate. Because for now CPOE is limited to medication orders, it is accomplished either in the course of e-Prescribing or by using the same workflow but not transmitting the prescription electronically, (e.g., when prescribing controlled substances or prescribing for patients who request a printed prescription.) All of these prescriptions count in the numerator of this meaningful use measure because they are entered into the ...