During the 1980’s and 90’s there were many studies done that showed that medical errors were occurring in inpatient and outpatient settings at a very high rate. Computer Provider Order Entry (CPOE) systems were designed to reduce or eliminate mistakes made by using hand written orders. The CPOE system allows users to directly enter their orders into the system on computers which are then sent directly to the healthcare providers that will be implementing the orders. Previously orders were placed by writing on order sheets on patient charts. This was sometimes done by the doctor or by a nurse acting on behalf of the doctor. Order sheets were then signed by the doctor and then the information was input into the patient’s record. This left room for error due to misreading bad handwriting, confusing medications with similar names, etc.
Emory Healthcare is part of the Emory University School of Medicine in Georgia. Emory Healthcare system is comprised of multiple inpatient hospitals and clinics within the state of Georgia. In response to the studies done in 2009 Emory rolled out the CPOE system in its inpatient units to try and reduce the number of errors occurring within their system. The COPE project at Emory Healthcare was thoroughly studied to understand the basic requirements needed by Emory prior to developing the system. While much went according to plan with the roll-out of the CPOE system, there were however several problems that Emory experienced in putting the system in place.
The pros of the CPOE system included that the prescribing of wrong medications was reduced, there were fewer errors with the patient’s basic information, orders for lab work, blood work, and medications were standardized; and mistakes in the ordering of wrong tests were eliminated. There were however many problems with the system as well including: Some doctors were not computer literate and they saw the system as a hindrance; some doctors were resistant to using the system as they felt the old system was working just fine; some orders could be entered incorrectly by the wrong entry on the computer; some doctors and nurses felt that the CPOE system shifted an unfair amount of the workload on the doctors and away from the nurses.
Some doctors believed that the CPOE system did not improve the quality of care as you needed to be computer literate in order to use it.
The change from the manual system to the CPOE system was met with mixed reactions.
Classes were held to train employees with the system and Emory used Application Content Experts, healthcare workers that had received special training in...