Episode 49: The Future is Computerized Provider Order Entry

In this podcast, Dr. Shawn Dowling explains the benefits and costs of the Computerized Provider Order Entry (CPOE), a complex healthcare intervention used for entering and managing orders.

“CPOE and EHR (Electronic Health Records) are the future of where patient health data is moving toward”, Shawn says.  Effective ways to enter, collect and communicate data bring benefits to providers and patients.  There are the potentials to reduce errors, increase patient safety, and maximize the use of information for appropriate medical decisions. Shawn highlights the importance of clinical decision support and describes how CPOE works as a tool to help physicians make the best decision at the point of care.

Cost, however, is the big downside of CPOE.  The management of data implies multimillionaire investments that limit its utilization to few departments and institutions. Time is the other challenge; it can take weeks, months or years before seeing the potentials linked to CPOE use. Furthermore, the communication among physicians and the patient-physician interaction have been affected since the implementation of CPOE in our hospital units.

Shawn ends his talk with a brief description of how, where, and when CPOE can be used. He brings examples from local experiences and the USA and emphasizes the inevitable use of CPOE for a better future in health care.

After listening to this podcast listeners will be able to:
1.  Understand the benefits of using CPOE
2.  Examine the challenges linked to its adoption
3.  Consider CPOE as inevitable choice for better and safer care

Dr. Shaw Dowling, MD
Dr. Shawn Dowling is an Emergency Medicine Physician, the Clinical Content Lead for the Calgary Zone Emergency Department and the Medical Director of the Physician Learning Program. Shawn earned his MD, research fellowship at the University of Ottawa, and completed a Royal College Emergency Medicine residency at the University of Calgary. He is passionate about knowledge translation and in particular, identifying gaps in care, appropriate resource usage and incorporating clinical decision support at the point of care.

References:

• Gray A, Fernandes C, Van Aarsen K, Columbus M. The impact of computerized provider order entry on emergency department flow. CJEM, 2016. Mar 28:1-6 https://www.ncbi.nlm.nih.gov/pubmed/27018711
• Syed S, Wang D, Goulard D, Rich T, Innes G, Lang E. Computer order entry systems in the emergency department significantly reduce the time to medication delivery for high acuity patients. International Journal of Emergency Medicine. 2013;6:20. doi:10.1186/1865-1380-6-20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707763/
• Netherton et al. Computerized physician order entry and decision support improves emergency department analgesic ordering for renal colic. Am J Emerg Med 2014. https://www.ncbi.nlm.nih.gov/pubmed/24997107
• Dowling S, Wang D, Rich T, Lang E. A Clinical Decision Support Intervention to Increase Usage of Probenecid in the ED. Canadian Journal of Emergency Medicine 18(S1):S90 · May 2016.
• Andrew Georgiou, PhD; Mirela Prgomet, BAppSc(HIM); Richard Paoloni, MBBS, MMed(ClinEpi); Nerida Creswick, PhD; Antonia Hordern, MHealthSc(CDM); Scott Walter, MBiostat; Johanna Westbrook, PhD. The Effect of Computerized Provider Order Entry Systems on Clinical Care and Work Processes in Emergency Departments: A Systematic Review of the Quantitative Literature. Annals of Emergency Medicine. Volume 61, Issue 6. Page 644.
• https://www.ncbi.nlm.nih.gov/pubmed/23548404 ED specific systematic review
• Black AD, Car J, Pagliari C, et al. The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview. Djulbegovic B, ed. PLoS Medicine. 2011;8(1):e1000387. doi:10.1371/journal.pmed.1000387.
• https://www.ncbi.nlm.nih.gov/pubmed/21267058