Using intranet-based order sets to standardize clinical care and prepare for computerized physician order entry

Area of Science:

• Health Informatics
• Clinical Workflow Optimization
• Healthcare Management

Background:

• High costs and physician resistance impede widespread adoption of computerized physician order entry (CPOE).
• Intranet-based order set systems offer a viable alternative to CPOE, promoting standardized care.
• The Clinician Order Forms (COF) system at MUSC was developed to leverage intranet technology for order entry and decision support.

Purpose of the Study:

• To evaluate the feasibility and impact of an intranet-based order set system (COF) as a precursor to CPOE implementation.
• To assess clinician willingness to develop and utilize digital order sets and decision support tools.
• To determine if the COF system could improve adherence to clinical best practices and core indicators.

Main Methods:

• Migrated 25 paper-based order sets to an intranet platform.
• Physician groups collaboratively developed over 200 additional order sets.
• Monitored intranet web traffic and decision support tool usage over a 24-month period.

Main Results:

• Significant increase in COF web traffic, reaching over 6,400 monthly hits.
• Clinician engagement in developing and using order sets and decision support tools was evident.
• Implementation of decision support tools led to improved compliance with core quality indicators.

Conclusions:

• Clinicians are receptive to using intranet-based order sets and decision support tools.
• The COF system serves as a cost-effective strategy for preparing healthcare institutions for CPOE adoption.
• COF facilitates acculturation towards standardized care and provides a foundation for future CPOE integration.