Insiders’ Insights

Computerized physician order entry systems are touted as useful tools in addressing patient safety. For many rural and community hospitals, the barriers to CPOE adoption can seem impossible to surmount. But CPOE is not the only option.

Denni McColm
Chief Information Officer
Citizens Memorial Healthcare
Bolivar, Mo.

CPOE is one tool that hospitals can use to address quality, patient safety and medication errors. It sends alerts directly to physicians that can help prevent errors from occurring. In our hospital, CPOE is used by all the physicians—about 45. We find that physicians change an order based on an alert one time per day. CPOE isn’t the only way to address these issues, but it is certainly one of the most efficient and effective tools available. An electronic medical record, which makes patient information available anywhere, anytime, is another important tool. You can have an electronic record without CPOE, but we found that having both integrated together is a powerful tool for our physicians. The challenges of CPOE in community and rural settings are cost, physician resistance, gaining and maintaining leadership support, and integration with other systems.

Stephen W. Clark
Chief Information Officer
Albemarle Hospital
Elizabeth City, N.C.

CPOE is not the panacea to improve quality and patient safety. There are other avenues to improve processes, such as clinical guidelines, which may get more adoption by the medical community in a rural setting, rather than herding physicians toward a computer-based model. Network infrastructure, work flow, computer literacy and investments in physician office systems are all potential barriers toward a successful technology-based solution. While Albemarle Hospital has several physicians clamoring to embrace CPOE, our thinking is focused on providing more access to clinical information and order entry for both the technology-savvy physician and the less computer-enabled physician. Our plan is to deploy a Web-based physician portal that will provide access to patient information from anywhere. Physicians will have the ability to order from the Web portal, an office-based system or hospital-based system.

—Carrie Vaughan