Doctor involvement key to success of computerized order entry

Hospitals with cultures of collaboration and trust show that good CPOE systems can be implemented and accepted.

By Tyler Chin, AMNews staff. March 17, 2003.

You can lead a physician to a computer, but you can't make him type. That may not come as a surprise to any physician whose hospital has instituted computerized physician order entry, but a study published in the March/April Journal of the American Medical Informatics Assn. bears out that conclusion.

Researchers found that hospitals with a culture of collaboration and trust that get doctors involved in designing and implementing CPOE systems end up with systems that physicians actually use.

Virtually every hospital that implements computerized physician order entry runs into problems along the way, including physician resistance, said Joan S. Ash, PhD, an associate professor of medical informatics at the School of Medicine at Oregon Health and Sciences University in Portland and lead author of the study.

Researchers studied the advent of CPOE systems at three hospitals -- the University of Virginia Health System, Charlottesville; the Veterans Affairs Puget Sound Health Care System, Seattle; and El Camino Hospital, Mountain View, Calif.

All three systems initially stumbled in their implementation.

The University of Virginia and the VA Puget Sound had to shut down their systems at one point because doctors believed the systems were too slow or compromised patient care. Still, both hospitals were able to recover because administrators had good relationships with doctors and got them involved in the project, Dr. Ash said.