Fostering Acceptance of Computerized Physician Order Entry

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First Review

This is a review of Fostering Acceptance of Computerized Physician Order Entry by Ivan S. Muslin, PhD; James M. Vardaman, PhD; Paul T. Cornell, PhD. [1]


Computerized physician order entry (CPOE) allows physicians to enter orders in a computer rather than handwriting them. Computerized physician order entry is touted as a major improvement in patient safety, and although the literature suggests that such systems have the potential to improve patient outcomes, studies also suggest that CPOE may have significant drawbacks that accompany those benefits. Physicians have often been resistant to accept its implementation. This study investigates the implementation of CPOE at a 217-bed rural hospital in the southeastern United States. Drawing on a mixed-method approach, we identify correlates of change acceptance and propose a set of recommendations for health care managers to foster acceptance of CPOE. Findings from physician surveys (n = 19) indicate that older physicians are less accepting of CPOE, but high-quality change communication may overcome resistance even among older physicians. With insights derived from the organizational change literature, findings bring to the fore a set of practices that managers can use to foster acceptance of CPOE. The thrust of these practices is that managers should make physicians active participants in fine-tuning CPOE within the unique needs and constraints of the local hospital setting.


This study was done in a 217- bed rural hospital that was undergoing the switch to CPOE. The physicians received a survey before CPOE "go live". There was a total of 100 physicians practicing in the hospital and 19 responded. 82% of participants were males; mean age was 48 with 20 years of experience in the field.


The results showed that age and communication were related to technology acceptance and job satisfaction was not. Change communication had the highest correlation with usefulness of technology acceptance.


The study concluded that the following can help with acceptance of CPOE: 1. Seek physician input throughout the implementation process, including during the very early stages. 2. Offer communication opportunities that treat physicians as active participants in fine-tuning the CPOE implementation. 3. Translate the CPOE technology to the local context so that inefficiencies are wrung out and poorly fitting parts of the technology are removed before they damage physician acceptance.


This study gives 3 pieces of advise on implementation of CPOE within an EHR. Seeking physician input and having a clear communication avenue helps physicians feel as if they are part of the process so this will empower them to use CPOE. This study was limited since the hospital only had a 19% response from their physicians.


  1. Muslin, I. S., Vardaman, J. M., & Cornell, P. T. (2014). Fostering Acceptance of Computerized Physician Order Entry: Insights From an Implementation Study. The health care manager, 33(2), 165-171.

Second Review

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