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Computerized provider order entry in pediatric oncology: design, implementation, and outcomes
Allen R Chen1, Christoph U Lehmann
1Departments of Oncology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Purpose:
Pediatric oncology is a challenging environment for computerized provider order entry (CPOE). Our goal was to build on the proven safety features of CPOE and facilitate input of expert clinicians.
Methods:
A standard, commercially available CPOE system was implemented throughout the hospital. The design of the pediatric oncology implementation was a collaborative effort by a multidisciplinary team of clinicians and information technology experts.
Results:
During 9 months of configuration effort, 30 medical logic modules and 110 order sets were developed to support pediatric oncology. The proportion of chemotherapy orders submitted using specific research protocol or standard-of-care order sets increased from 57% to 84% as the number of active order sets grew to 200. The number of medication-related patient safety events decreased 39% after implementation of CPOE in pediatric oncology. Acceptance of the system is high in all clinical disciplines.
Conclusion:
Implementation of CPOE required extensive customization but improved patient safety in this highly complex pediatric oncology environment.
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