THE ROLE OF COMPUTERIZED PHYSICIAN ORDER ENTRY SYSTEM IN OWERRI-NIGERIA

The Role of Computerized Physician Order Entry System in Owerri-Nigeria



Table of Contents

CHAPTER 4: HOW DO CPOE AFFECT THE QUALITY OF PATIENTCARE AND SAFETY?1

4.1 Introduction1

4.2 Definition of CPOE and CDSS1

4.3 The order entry process4

4.4 CPOE and Patient Safety7

4.5 Benefits of CPOE:8

4.6 Summary9

CHAPTER 5: BARRIERS AND ISSUES REEATED TO IMPLEMENTATION OF A CPOE12

5.1 Introduction12

5.2 Incorporation with other Hospital's Information13

5.3 Implementation of CPOE:14

5.4 Barriers to implementations of CPOE:15

5.5 Case Study One: St. David's Hospital26

5.6 Case Study two: Concord Hospital29

5.7 Summary:31

CHAPTER 6 CONCLUSIONS SUMMARY AND RECOMMENDATION33

6.1 Conclusion33

6.2 Recommendation35

6.3 Summary38

References41

CHAPTER 4: HOW DO CPOE AFFECT THE QUALITY OF PATIENTCARE AND SAFETY?

4.1 Introduction

This chapter discusses clinical Decision Support techniques and methods in the Computerized Physician Order Entry-CPOE and its effects on the quality of patient safety and care in Nigerian hospitals. The chapter focuses on the application of the system in hospitals and the effect of occurrence of error in medication and occurrence of preventable adverse drug events.

CPOE is used in combination with a CDS or at times with the entire CDSS. The Clinical Decision Support tools are among the important factors to be considered while selecting CPOE as a solution for a hospital. The Clinical Decision Support is a proficient system designed for the practitioners. It enables them to search a related database of drugs to acquire latest information, recommended dosage, entry routes, adverse interactions, etc, in hospitals. (Cordero, Kuehn, Kumar, Mekhjian, 2004)

In the current market scenario, numerous software firms offer a variety of CDSS and CPOE systems. However, some health care facilities have shown favorable results, yet, some are still having problems while implementing the systems. Of the many offerings in the market, what differentiates one from another is the level of embedded CDSS, sophistication of rules, alerts, algorithms and other features.

4.2 Definition of CPOE and CDSS

Computerized Provider Order Entry (CPOE) is a computer application that accepts the provider's (physician, pharmacist or nurse) orders for medications, laboratory tests, diagnostic radiology and other diagnostic tests. CPOE replaces the manual process whereby the provider's record orders using paper-based methods. The immediate interest in CPOE is focused on medication order entry and its potential to reduce medication prescribing errors. The application can compare the orders against standards for dosing, check for allergies or interactions with other medications and warn the physician about potential problems. (Cordero, Kuehn, Kumar, Mekhjian, 2004) CPOE system may also reduce costs through avoiding adverse events, reduced utilization and shorter lengths of stay, and reduce unnecessary variations in care by encouraging recommended care practices. However, unintended consequences and CPOE induced errors can stem from improper design and implementation. There are many reports of failed CPOE implementation and a low rate of the adoption of this technology. The reasons for the failure of an implementation are undertaken in three acute care hospitals. They highlighted financial pressures, personal unwillingness to change and integrator inexperience with health care. In addition to those reasons, other studies have reported lack of medical professional (clinician) involvement, inadequate capture and ...