Computer-based physician order entry: the state of the art

Area of Science:

• Health Informatics
• Clinical Information Systems
• Medical Technology Adoption

Background:

• Computer-based physician order entry (CPOE) has been debated for over two decades.
• Implementation success varies, with some sites experiencing failures, delays, and cost overruns.
• CPOE aims to improve processes, support cost-effective decisions, enhance clinical decision support, and optimize physician time.

Purpose of the Study:

• To review the peer-reviewed scientific literature on the current state of computer-based physician order entry.
• To identify key factors contributing to both the success and failure of CPOE implementation.

Main Methods:

• Systematic review of peer-reviewed scientific literature.
• Analysis of reported implementation experiences, including successes and failures.

Main Results:

• Barriers to CPOE adoption include necessary changes in practice patterns, team roles, teaching, and institutional policies.
• Critical success factors include system speed and ease of use, consistent user interface behavior, and clinician involvement.
• Sustained commitment from top leadership and regular collaboration between problem solvers and users are essential.

Conclusions:

• Successful CPOE implementation hinges on addressing practice changes and ensuring system usability.
• Strong clinical and leadership engagement, alongside dedicated problem-solving groups, are vital for overcoming CPOE challenges.
• The review synthesizes current knowledge on CPOE to guide future implementations.