This appeared a few days ago.
Story posted: March 26, 2008 - 5:59 am EDT
Joel Berman is in an enviable position for a chief medical information officer.
Six months into a slow-roll implementation of a computerized physician order entry system at 220-bed Concord (N.H.) Hospital, Berman has had not one medical staff delegation show up at his door with flaming torches. In the CPOE business, that is not damnation with faint praise.
On the contrary, a recently completed survey of medical staff physicians gives Berman cause for optimism, and in one case, surprise.
“We had implemented CPOE in September 2007, and six months later we wanted to find out our providers’ point of view,” Berman said. “What was working well? What did they like? What did they want different?”
So far, about 80 of the 300 or so physicians with privileges at Concord are using McKesson Corp.’s Horizon Expert Orders CPOE system, Berman said. Thirty-three of them answered questions in the online survey, with solid majorities (between 72% and 94%) rating the system “very easy” or “easy” to use for finding and entering orders for medication, laboratory results, diagnostic tests, and support orders for dietary, physical and occupational therapy.
Not surprisingly, given those relatively high marks for functionality and ease of use, 81% of the doctors surveyed rated their CPOE training as excellent or good while 88% gave the same positive ratings for on-going support. Fifty-three percent of physicians concluded that using the system yielded a significant (6%) or slight (47%) improvement in the quality of care.
What was unexpected, Berman said, was the perceived impact on efficiency.
“In general, physicians are not the most happy stakeholders in the equation because CPOE requires them to do order-entry at a detail that previously they hadn’t,” Berman said. “Providers are used to (Microsoft) Windows functionality and so they expect to be able to minimize screens and to right click and get definitions and I don’t know of any (CPOE) system that has that. CPOE is not time-neutral, especially early on.”
Although Berman said Concord has not put a stopwatch to specific order writing, for many physicians plugging away at an unfamiliar system, a common perception is that for certain tasks it takes longer with CPOE than with paper. Even so, Berman said he was heartened by physician responses to questions about the impact of the system on efficiency of care.
While just 6% of physicians found the system significantly increased their efficiency, 34% responded efficiency increased slightly and another 12% reported no change. And while 41% reported it decreased efficiency slightly and another 6% significantly, Berman is more than satisfied with those numbers so far.
Much more here:
There was also a comment on the article a little later.
Story posted: March 27, 2008 - 5:59 am EDT
In response to Joseph Conn's "Concord Hospital sees positive CPOE outcomes":
This article is very heartening. It certainly had the necessary ingredients for a successful information technology project: good technology, competent IT management and most importantly, full support from top management. Take any of those ingredients away and you will see the flicker of torches outside the IT office.
The comment was from:
Tom Mariner, Vice president, Software and IP, Quantum Medical Imaging, Ronkonkoma, N.Y
The bottom line here is that real clinical benefits are being delivered to the patients of this organisation and they are being monitored – with the feedback provided encouraging further system adoption.
This is good news from the real coal face!