Patterns and Perceptions of Standard Order Set Use Among Physicians Working Within a Multihospital System: Mixed
Sundresan Naicker1, Amina Tariq1, Raelene Donovan2
1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia.
Electronic standard order sets improve healthcare efficiency but their adoption is complex. Customizing these order sets based on user experience and local context is key to increasing their use in hospitals.
Area of Science:
- Health Informatics
- Clinical Workflow Optimization
- Behavioral Science in Healthcare
Background:
- Electronic standard order sets are tools within Electronic Medical Records (EMRs) designed to standardize clinical protocols.
- While implemented routinely, understanding their actual usage and adoption factors remains limited.
- These tools aim to reduce clinical variation and enhance healthcare efficiency.
Purpose of the Study:
- To describe standard order set usage patterns in a multihospital EMR system.
- To explore user and implementer perceptions of factors influencing order set adoption.
- To map findings to the Capability, Opportunity, and Motivation Behavior (COM-B) model for improved implementation.
Main Methods:
- Quantitative analysis of order set usage data from 5 hospitals over 3 years (2019-2021).
- Qualitative data collection through 15 semi-structured interviews analyzed thematically.
- Mapping interview themes to the COM-B model to identify usage determinants.
Main Results:
- Order set usage increased from 267,253 in 2019 to 335,066 in 2021, with a shift towards upgraded specialty order sets.
- Clinician interviews revealed themes of Knowledge and Skills, Perceptions, Technical Dependencies, and Unintended Consequences.
- A user preference for customized order sets that adapt to local context and experience was identified.
Conclusions:
- Investing in the development and customization of specialty order sets can enhance their usage.
- Successful adoption requires implementation strategies addressing capability, opportunity, and motivational factors.
- Tailoring order sets to local context and user experience is crucial for sustained Computerized Provider Order Entry use.
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