Computerized physician order entry and communication: reciprocal impacts.

Area of Science:

• Health Informatics
• Healthcare Management
• Organizational Communication

Background:

• Computerized Physician Order Entry (CPOE) systems are increasingly adopted in healthcare settings.
• Implementation of CPOE can lead to complex organizational and communication challenges.
• Understanding these challenges is crucial for successful technology adoption in hospitals.

Purpose of the Study:

• To identify success factors for Computerized Physician Order Entry (CPOE) implementation.
• To explore the unanticipated impacts of CPOE on communication channels and relationships within healthcare organizations.
• To provide recommendations for healthcare institutions implementing CPOE systems.

Main Methods:

• Utilized participant observation, focus groups, and oral history techniques for data collection.
• Conducted data analysis across four diverse U.S. sites.
• Examined data for both initial success factors and subsequent communication issues.

Main Results:

• CPOE implementation significantly impacted communication channels and interpersonal relationships.
• Observed varied effects on physician-nurse interactions, pharmacy roles, and patient communications.
• Identified bi-directional information flow between administration and staff as potentially "mission-critical".

Conclusions:

• Healthcare organizations should "plan to be surprised" by CPOE implementation.
• Unforeseen consequences are inevitable despite careful planning and pre-work.
• A prepared and capable implementation support group is essential for managing CPOE-related disruptions.