Extending the understanding of computerized physician order entry: Implications for professional collaboration, workflow and quality of care

被引:102
作者
Aarts, Jos [1 ]
Ash, Joan [2 ]
Berg, Marc [1 ]
机构
[1] Institute of Health Policy and Management, Erasmus University Medical Center, 3000 DR Rotterdam
[2] Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR 97239-3098
关键词
Computerized; Computerized physician order entry; Hospital information systems; Medical records systems; Online systems; Qualitative research; Quality of care;
D O I
10.1016/j.ijmedinf.2006.05.009
中图分类号
学科分类号
摘要
Objective: To describe the perceived effect of computerized physician order entry (CPOE) on professional collaboration, workflow and quality of care. Design: Semi-structured interviews with experts involved in the design, implementation and evaluation of computerized physician order systems in the United States. Measurements: The interview transcripts were analyzed using six key concepts that identify context, professional collaboration, workflow and quality of care. Results: The interviews reveal the complexity of CPOE. Although providers enter the orders, others collaborate in the decision-making process. There is a profound impact on workflow beyond that of the provider. While quality of care is the main impetus for implementation, it remains terribly difficult to measure the impact on quality. Conclusions: A proper understanding of CPOE as a collaborative effort and the transformation of the health care activities into integrated care programs requires an understanding of how orders are created and processed, how CPOE as part of an integrated system can support the workflow, and how risks affecting patient care can be identified and reduced, especially during hand-offs in the workflow. © 2006 Elsevier Ireland Ltd. All rights reserved.
引用
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页码:S4 / S13
页数:9
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