A Computerized Physician Order Entry (CPOE) system has been instrumental in providing physicians with a valuable alternative to using prescription pads or paper forms. Not only is it a more efficient alternative, its major benefit is the safety quotient that it offers. In this system, orders are incorporated with patient information e.g. radiology/lab results and there are automatic checks in place to catch hold of errors and problems which if allowed to be committed have the potential to cause a fatal outcome. The system has also been highly effective in reducing errors associated illegibility as well as inappropriate drug use & dosing. Overall, by using a (CPOE) there is a considerable reduction in medical errors and adverse drug events (ADEs). The need to use a system was triggered by a report by Institute of Medicine (IOM).

The report which was published indicated that the various healthcare improvement agendas ought to be channelized towards patient safety and error reduction. It brought to the forefront the fact that medical errors were not uncommon & that the largest number of errors traced involved medication. These involved prescribing medications to which either the patient was allergic and prescribing inappropriate dosage. Also it was seen that Adverse Drug Events contributed in a major way to an increase in patient stay in hospitals. Revelation of all this information brought to the forefront critical issues which needed immediate attention & possible solutions. The focus clearly needed to shift towards enhanced error reporting, designation of qualified individuals to lead the safety improvement efforts, & risk identification and reduction programs.

Use of technology & application, in the form of a CPOE system, got introduced as a solution to tackle the issues which were proving to be matters of high concern. It required practitioners to enter orders into a system & get them transmitted electronically to appropriate departments. To help reduce incidences of errors, alerts and decision support system, clinical guidelines were also integrated into the system. Since then on, various studies have been done to figure out how effective the adoption and implementation of the system has been. Some of the benefits which have been commonly reported are increase in efficiency, reduction in overall costs, reduced length of medical stay & a decrease of medical errors i.e. reduction in inappropriate medication selection, inappropriate dosing and inappropriate frequency of medication administration . Some of the other common order-entry errors like overlooking of drug allergies, drug-drug interactions, drug-laboratory value interactions & drug–disease interaction were also easily avoided.

Although the overall evaluation of Computerized Physician Order Entry system has been positive in terms of the tangible benefits that it offers, the surprising factor has been the pace of its adoption which has falling short of expectations. There are a few reasons cited for lack of voluntary adoption. The major reason seems to be the willingness among physicians and hospital authorities to bring about the required change in their work flows to accommodate the change. Also it requires a certain amount of investment; both for the implementation of the system as well as for training resources to use the system. However the push provided by CMS meaningful use program is getting providers to adopt the system at a faster rate now.

Mindfire Solutions has been successful in implementing Healthcare projects for the last 10+ years. With expertise in having executed multiple Health IT projects across areas like EMR/EHR, PMS, Ambulatory Care System, LIMs, Medical Billing, CPOE, Clinical Management Systems as well in mHealth, we are preferred technology partner for many of clients in need of developing standard as well as customized healthcare solutions meeting all the regulatory guidelines.

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