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Same systems, different outcomes--comparing the implementation of computerized physician order entry in two Dutch
1Institute of Health Policy and Management, Erasmus University Medical Center, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. j.aarts@erasmusmc.nl
Methods of Information in Medicine
|February 17, 2006
Summary
Implementing computerized physician order entry (CPOE) systems requires focusing on medical work and support structures. Understanding these factors is key to successful CPOE adoption and improved healthcare outcomes.
Area of Science:
- Health Informatics
- Medical Systems Implementation
- Healthcare Management
Background:
- Computerized Physician Order Entry (CPOE) systems are increasingly adopted in healthcare settings.
- Evaluating the implementation process of CPOE is crucial for optimizing its benefits.
- Understanding factors influencing CPOE success is vital for healthcare organizations.
Purpose of the Study:
- To compare the outcomes of implementing Computerized Physician Order Entry (CPOE) systems in two distinct Dutch hospitals.
- To identify key factors contributing to the success or failure of CPOE implementation.
Main Methods:
- Qualitative research approach utilizing interviews, system observations, staff meeting observations, and document analysis.
- Analysis of transcribed texts and implementation documents to identify relevant concepts.
- Application of a heuristic success and failure model, focusing on medical work, to analyze transcripts and field notes.
Main Results:
- Identified specific occasions and factors that significantly influenced the outcome of CPOE implementation.
- Classified implementation determinants based on their potential to promote or hinder system success.
- Highlighted variations in implementation outcomes between the two studied hospitals.
Conclusions:
- Validated the centrality of medical work in analyzing CPOE implementation models.
- Introduced the concept of a 'support base' as essential for healthcare professionals to adapt to changes introduced by CPOE.
- Emphasized that understanding medical work and the necessary support structures can explain differing CPOE implementation outcomes.
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