Computerized Provider Order Entry Adoption: Implications for Clinical Workflow

Background

This article describes some of the impact that Computerized Provider Order Entry (CPOE) can have on clinical workflow. Physicians use CPOE to order things such as labs, medications, and imaging. Although CPOE can reduce costs, reduce errors, and promote standardization, and reduce redundancy in orders, it can also negatively impact clinical workflow.

Methods

The researchers visited 5 hospitals over a period of three years and collected data. They collected their data via interviews and by shadowing clinicians which included physicians, nurses, pharmacists, and the administrator. The clinicians were asked to report unintended consequences related to CPOE.

Results

Some of the issues or disruptions in workflow were reported as:

• Functional design and shortage of workstations
• Cluttered screen design and space
• Lack of relevant safeguards
• Lack of intraoperability with other systems, such as viewing lab results
• Rigidity of ordering medications, with little room for modifying
• Safety alerts appearing at non-applicable settings

Conclusion

Although CPOE can help in increasing efficiency, reducing costs and errors, it can also have adverse consequences. Clinical workflow can be greatly impacted by CPOE by concerns over rigidity of the system and workstation, accomodating different clinical specialists using CPOE, and lack of ability to function with other systems.