10 make or break steps to CPOE

Check out HealthLeaders Magazine’s November Cover Story: Bring Order to CPOE With 10 Make or Break Steps (and 5 myths). Nothing groundbreaking but it’s a good overview into computerized physician order entry system deployment.

Shocker: it’s a people problem, not a technology issue! 🙂

One universally good point they make:

If CPOE masters agree on one strategy, it’s this: To succeed, a CPOE implementation must be the top priority initiative across the hospital. Any other major technological or cross-departmental initiative must be postponed during the roll-out. Moreover, the hospital’s “C-suite” of management executives must support the effort.

Another important observation:

Look to the payroll of hospitals that have incorporated CPOE and you will find salaried physicians who are dedicated, at least part time, to the effort. The project is just too high-risk and too time-consuming to leave in the hands of volunteers, CPOE veterans say. Physician champions can solicit the vital political support of department chairs and spearhead the creation of order sets needed to make the system work.

On training:

Behind every stalled CPOE project lurks inadequate training. “It’s not a ‘fire-and-forget’ application,” cautions Stephen Smith, former chief technology officer at the University of Pennsylvania Health System, which is wrapping up its CPOE installation across three hospitals. Having trainers and support staff available around the clock is critical, Smith says, adding that his support crew fielded 40 calls a day. “Once a hospital becomes dependent on CPOE, it raises the bar for the IT department. There is absolutely zero tolerance for down time. You need to support the application or you will pay a price.”

Top Five CPOE Myths:

1. It’s a clerical technology – nonsense, it requires clinical skills to use
2. It doesn’t require resident buy-in – keep the residents out at your own peril
3. Alerts are its strong point – nonsense, alerts may cause lower adoption not higher due to alert fatigue
4. It slows down physicians – once over the learning curve, over time, it’s not’s slower
5. It’s a medical errors panacea – nope, it’s overhyped