Web-based physician order entry: an open source solution with broad physician involvement

Computerized physician order entry (CPOE) is a disruptive technology but holds great promise for reducing medical errors, improving workflow and in the long run, producing cost-savings. However, many studies have reported significant physician resistance to implementing CPOE. In this manuscript we present a two-prong strategy for quick implementation of CPOE: 1) a web-based deployment tool using an open source, secure environment that allows rapid development and deployment of content, and 2) the development of a large set of disease specific order sets and knowledge bases based on established vocabulary standards such as LOINC and SNOMED CT by teams of multidisciplinary content experts at the departmental level. The order sets can be viewed, edited and signed through a standard browser interface. This paper presents the conceptual framework and implementation requirements for such an endeavor.