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The effect of computerized provider order entry (CPOE) on ordering patterns for chest pain patients in the emergency

Terrence J Adam1, Russ Waitman, Ian Jones

  • 1Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, MN, USA.

AMIA ... Annual Symposium Proceedings. AMIA Symposium
|December 24, 2011
PubMed

Insights

Computerized provider order entry (CPOE) implementation significantly increased emergency department order volume and improved documentation completeness for chest pain patients. Turn-around times for clinical testing remained largely unaffected.

Area of Science:

  • Health Informatics
  • Emergency Medicine
  • Clinical Workflow Analysis

Background:

  • Electronic health records are increasingly adopted in healthcare settings.
  • Computerized provider order entry (CPOE) systems aim to improve order accuracy and efficiency.
  • The impact of CPOE on emergency department (ED) ordering patterns requires further investigation.

Purpose of the Study:

  • To evaluate the effect of CPOE implementation on the ordering patterns of chest pain patients in the ED.
  • To assess changes in order volume, completeness, and completion times before and after CPOE adoption.

Main Methods:

  • Retrospective analysis of clinical order data for 300 time-matched chest pain patients.
  • Comparison of ordering patterns in a pre-CPOE and post-CPOE implementation period.
  • Assessment of patient demographics, treatments, disposition, order volume, completeness, and completion times.

Main Results:

  • Overall order volume significantly increased post-CPOE implementation (11.6 to 19.9, p<.01).
  • Order documentation completeness improved significantly, with fewer deficiencies noted post-implementation.
  • Laboratory completion times increased for admitted patients, while overall order completion times remained unchanged.

Conclusions:

  • CPOE implementation is associated with increased order volume and improved clinical documentation in the ED for chest pain patients.
  • The study suggests CPOE enhances the capture of admission orders for admitted patients.
  • While documentation improved, CPOE had a limited impact on clinical testing turn-around times.

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