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Order creation and communication in healthcare
P N Gorman1, M B Lavelle, J S Ash
1Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd. Portland, OR 97239-3098, USA. gormanp@ohsu.edu
Methods of Information in Medicine
|October 10, 2003
Summary
Physician Order Entry (POE) systems are inadequate for clinical settings. Orders emerge from multidisciplinary collaboration, not just physician input, requiring better integration into patient care systems.
Area of Science:
- Health Informatics
- Clinical Systems Analysis
- Human-Computer Interaction
Background:
- Physician Order Entry (POE) is a common model for clinical information systems.
- The adequacy of POE as a sole model for clinical systems requires examination.
- Understanding the order creation and communication process is crucial for effective healthcare delivery.
Purpose of the Study:
- To critically evaluate the suitability of the Physician Order Entry (POE) concept.
- To propose an alternative framework for understanding clinical order processes.
- To enhance the design and implementation of clinical information systems.
Main Methods:
- Interpretative analysis of the Physician Order Entry (POE) model.
- Qualitative fieldwork involving observations of clinical practice.
- Analysis of order creation and communication dynamics in real-world settings.
Main Results:
- Clinical orders emerge from dynamic, multidisciplinary interactions involving patients, healthcare professionals, and families.
- The process involves diverse technologies and information resources.
- Orders are negotiated within evolving groups with shifting roles and responsibilities.
- Orders represent only a partial view of comprehensive patient care.
Conclusions:
- Information systems should support POE as a collaborative, multidisciplinary effort.
- Clinical systems must better integrate into the broader patient care ecosystem.
- Rethinking POE can lead to more effective and supportive healthcare information systems.
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