History

As early as 1970, when Collen listed several of the general objectives of a medical information management system,’ he included “to communicate patient data from professionals providing medical care (doctors, nurses, technicians, etc.) into the patient’s computer-based medical record, to other professionals (e.g., dietitians), and to hospital services (e.g., radiology).” He specifically stated that “Physicians should enter medical orders directly into the computer” as a means of ensuring quality.

An important distinction must be made regarding the fundamental approaches taken by different developers of CPOE systems. The first attempts, such as those by Technicon Data Systems (formerly known as TDS Healthcare Systems Corp. and now owned by Eclipsys Corp.), were to develop hospital information systems for use by clinicians. They identified CPOE as one of their primary objectives at the outset. A second group of investigators focused early efforts on developing a computer-based patient record, or on clinical decision-support systems. Direct provider order entry was then added as an extension. The first group focused upon implementing straightforward CPOE for inpatients house-wide, while the second group explored more elaborate functionality for small classes of users, in a mixture of outpatient and inpatient settings. (See Sittig and Stead, 1994 for more background information).

References

Collen MF. General requirements for a Medical Information System (MIS). Comput Biomed Res. 1970 Oct 5;3(5):393-406.

Sittig DF, Stead WW. Computer-based physician order entry: the state of the art. J Am Med Inform Assoc. 1994 Mar-Apr;1(2):108-23.