This webpage presents the results of research by the Physician Order Entry Team (POET) at Oregon Health & Science University. The team is funded by a grant from the National Library of Medicine to study success factors for implementing Computerized Physician Order Entry (CPOE) as well as the unintended consequences of CPOE. This site also provides access to a collection of resources and links regarding CPOE.
Computerized physician/provider order entry is defined as the computer system that allows direct entry of medical orders by the person with the licensure and privileges to do so. Directly entering orders into a computer has the benefit of reducing errors by minimizing the ambiguity of hand-written orders, but a much greater benefit is seen with the combination of CPOE and clinical decision support tools.
Implementation of CPOE is being increasingly encouraged as an important solution to the challenge of reducing medical errors, and improving health care quality and efficiency. But use of CPOE is not yet widespread, in part because it has a reputation for being difficult to implement successfully.
The SAFER guides
The POET group of researchers was instrumental in developing the SAFER (Safety Assurance Factors for EHR Resilience) guides for EHR safety, published by the Office of the National Coordinator for HIT in January of 2014. This series of self-assessment guides was developed to assist health care organizations, health care professionals, and others to evaluate certain high-risk components of their EHR-enabled clinical work systems. To help improve patient safety, these guides focus on eight specific risk areas: computerized provider order entry (CPOE) with clinical decision support (CDS); clinician communication; patient identification; contingency planning; organizational responsibilities; system configuration; test result reporting and follow-up; and system interfaces. In addition, a guide to the highest priority issues throughout the guides was also developed for use as a starting point for guide users.The overall purpose of the SAFER guides’ development effort was to produce proactive self-assessment guides that will help ensure the safe implementation and use of electronic health record (EHR) systems and avoid harm to patients.
Click on the following documents for more information:
In 1994, Sittig and Stead wrote a landmark article on Computerized Physician Order Entry (CPOE). Much has changed in the field in the past ten years plus. The bibliography on this website is intended as a sequel to the Sittig and Stead paper. We have not included articles published before 1994, as Sittig and Stead’s “State of the Art” summarized the literature to that point nicely.
The current readings have been selected specifically for those involved in implementation of systems, clinicians, administrators and IT professionals including implementation support staff. It is designed to give these individuals a streamlined overview of the CPOE literature. We hope to offer a “jump-start” for reading in the area, and provide a framework for the reader’s own ideas and notes.
The Physician Order Entry Team at Oregon Health & Science University has, for the past 12 years, been, and continues to be, actively engaged in research on Computer Physician Order Entry (CPOE) and continues with Computerized Decision Support (CDS) inside and outside CPOE. We started accumulating a CPOE database in 2004. With our move to CPOE/CDS we saw the need for a more concentrated bibliography of CDS articles and began to develop a CDS bibliography.
Articles for this new CDS bibliography were identified by searching National Library of Medicine MEDLINE electronic bibliographic database, from January 1, 1994 to December 10, 2009 using search concepts (with appropriate synonyms): Decision Making, Computer Assisted; Decision Support Systems, Clinical; Medical Order Entry Systems; Medication Systems; Medication Systems, Hospital; Clinical Pharmacy Information Systems; Reminder Systems; Drug Therapy, Computer-assisted; Medical Records systems, computerized; Hospital Information Systems and Diagnosis, computer assisted. The Cochrane Collection and CINAHL were searched similarly. This strategy was supplemented by articles identified as key in the reference sections. In addition, bibliography users have suggested additions which are always welcome. This remains a work in progress as we fill it out and attempt to keep it up-to-date.