Dimensions associated with successful implementation of a hospital based integrated order entry system

Area of Science:

• Health Informatics
• Healthcare Management
• Information Systems

Background:

• Implementing electronic medical records necessitates direct physician order entry (POE).
• POE adoption involves significant systemic, behavioral, and attitudinal changes across healthcare.
• Understanding facilitating and impeding factors is crucial for successful POE implementation.

Purpose of the Study:

• To identify key facilitating and impeding factors for physician order entry (POE) implementation.
• To explore how these factors influence POE success in hospitals.
• To analyze variations in perceived importance based on institutional roles.

Main Methods:

• Modified Delphi method with a diverse group of stakeholders.
• Q-sort methodology to categorize identified factors.
• Comparative analysis of factor mentions between successful and unsuccessful hospitals.

Main Results:

• Twenty systemic, behavioral, and attitudinal dimensions were identified as critical for POE success.
• While functionality was commonly cited, hardware availability, physician involvement, and administrative support differentiated successful from less successful hospitals.
• Perceived importance of factors varied by role: support staff emphasized organizational variables, while clinicians prioritized administrative and leadership support.

Conclusions:

• Successful POE implementation depends on a combination of technical and organizational factors.
• Addressing physician engagement and administrative backing is vital for overcoming implementation barriers.
• POE adoption is a system-wide change requiring attention to both individual and organizational dynamics.