Computerized physician order entry: lessons learned from the trenches

Implementation of computer physician order entry (CPOE) demands planning, teamwork, and a steep learning curve. The nurse-driven team at the hospital unit level is pivotal to a successful launch. This article describes the experience of one NICU in planning, building, training, and implementing CPOE. Pitfalls and lessons learned are described. Communication between the nurse team at the unit and the clinical informatics team needs to be ongoing. Self-paced training with realistic practice scenarios and one-on-one "view then practice" modules help ease the transition. Many issues are not apparent until after CPOE has been implemented, and it is vital to have a mechanism to fix problems quickly. We describe the experience of "going live" and the reality of day-to-day order entry.