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Ambulatory computerized physician order entry implementation.

Joan S Ash1, Homer L Chin, Dean F Sittig

  • 1Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, Portland, OR, USA.

AMIA ... Annual Symposium Proceedings. AMIA Symposium
|June 17, 2006
PubMed
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Implementing computerized physician order entry (CPOE) in ambulatory settings requires attention to technology, organization, and personnel. This study identified unique success factors for outpatient CPOE implementation, differing from inpatient settings.

Area of Science:

  • Health Informatics
  • Healthcare Management
  • Qualitative Research Methods

Background:

  • Computerized Physician Order Entry (CPOE) systems are crucial for improving healthcare quality and safety.
  • Understanding success factors for CPOE implementation is vital, particularly in diverse clinical settings.
  • Previous research has focused on inpatient CPOE, necessitating specific investigation into ambulatory environments.

Purpose of the Study:

  • To identify and describe success factors for implementing CPOE in an ambulatory care setting.
  • To compare findings from outpatient CPOE implementation with existing inpatient CPOE research.
  • To provide insights for optimizing CPOE adoption in clinics and physician practices.

Main Methods:

  • A qualitative research approach was employed over seven months at four Kaiser Permanente Northwest clinics.

Related Experiment Videos

  • A multidisciplinary team conducted observations, interviews, and focus groups.
  • Data analysis utilized a combination of template and grounded theory approaches.

    • Main Results:

    • Fourteen distinct themes were identified, categorized into technology, organizational, personal, and environmental factors.
    • Specific outpatient CPOE success factors emerged, highlighting unique challenges and facilitators in ambulatory care.
    • Findings showed both similarities and subtle differences compared to previously reported inpatient CPOE implementation studies.

    Conclusions:

    • Successful ambulatory CPOE implementation depends on a nuanced understanding of technology, organizational culture, individual user factors, and the external environment.
    • The identified themes offer practical guidance for healthcare organizations aiming to implement or optimize CPOE in outpatient settings.
    • Further research comparing outpatient and inpatient CPOE success factors can refine implementation strategies across different healthcare delivery models.