Working hard for the data (Toward an Electronic Patient Record meeting)

Proponents of computerized physician order entry point to the efficiencies of electronic medical records. Opponents say these systems just pile more work on physicians, and the payoff isn't there yet.

By Tyler Chin, AMNews staff. June 13, 2005.

Reports from conferences important to physicians

Is adoption of computerized physician order entry ready for takeoff? Judging by year-to-year growth in CPOE adoption, and from interviews of physicians attending the 21st annual Toward an Electronic Patient Record conference May 16-18 in Salt Lake City, the answer is yes. But 20 years of history says -- not so much.

Physicians are entering orders electronically in about 4% of the country's hospitals, up from 3.2% in 2004, said Jason Hess, director of business development of KLAS Enterprises LLC, an Orem, Utah-based health technology market research firm.

A major reason for the rise is 163% growth in nonteaching facilities using CPOE, compared with 60% growth in teaching facilities, which overall make up the majority of hospitals using CPOE, Hess told conference attendees. "I think what this represents is privileged non-employed physicians are embracing CPOE and are starting to do a lot more with this compared to where we were in years past," he said.

But while the increase in the rate of adoption is encouraging for CPOE proponents, the reality is that CPOE is one of the least adopted technologies in health care, despite being around for more than two decades. "It's still very much in its infancy," said Adam Gale, vice president of operations at KLAS Enterprises.

There are several reasons that few hospitals and doctors use CPOE, which calls on physicians to enter hospital orders themselves into a computer system. These include cost; a culture in which physicians are used to writing and handing orders to nurses and clerks; and the fact that vendors sell systems that are poorly designed for physician use. Doctors also haven't adopted CPOE because it takes time and doesn't make their job easier or better, critics say.