Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE

Abstract

KeywordsComputer provider order entry, clinical decision support, electronic medical record Summary Background: Many resident physicians have experienced transitioning from traditional paper documentation and ordering to an electronic process during their training. Objective: We sought to investigate the attitudes and perceptions of residents related to implementation of computer provider order entry (CPOE) and clinical decision support (CDS). Methods: Pediatric residents completed web-based surveys prior to CPOE implementation and at 6 months and 12 months after implementation. The survey assessed resident attitudes and perceptions related to CPOE and the use of CDS tools. Additionally, at 6 and 12 months, residents were asked how electronic medical record (EMR) resources might impact future career decisions. Results: Prior to CPOE implementation, 70% of residents were looking forward to CPOE, but 28% did not want to transition from paper ordering. At 12 months post-implementation, 80% of residents favored CPOE over paper ordering and only 3.33% wished to revert to paper ordering. Residents reported an increase in time needed to enter admission orders 6-months after CPOE implementation. By 12 months post-implementation, there was no significant difference in perceived time to complete admission orders when compared to pre-CPOE responses. Most residents (91.67%) identified that overall EMR resources were an important factor when considering future employment opportunities. The most important factors included the degree of EMR implementation, technology resources and the amount of support staff. The least important factors included patient portal access and which EMR product is used. Conclusions: Overall, residents demonstrated a preference for CPOE compared to traditional paper order entry. Many residents remained unaware of CDS tools embedded within CPOE at the 12 month follow-up, but a majority of residents did find them helpful and felt more knowledgeable about current guidelines. EMR resources, including degree of EMR implementation, technology resources and support staff are likely to be important factors as residents take future employment opportunities into consideration.

Physicians’ Use of the Computerized Physician Order Entry System for Medication Prescribing: Systematic Review

“…Multimedia Appendix 2 [ 24 - 34 ] summarizes the characteristics of the included studies. The 11 studies included in the review were from different regions of the world: 4 are from the United States [ 24 - 27 ], 3 are from Sweden [ 28 - 30 ], 1 is from the Netherlands [ 31 ], 1 from Saudi Arabia [ 32 ], 1 from Australia [ 33 ], and 1 from Singapore [ 34 ]. Of the total number of studies, 4 used qualitative methods (interviews) [ 24 , 25 , 29 , 33 ], 6 used quantitative methods (surveys or questionnaires) [ 26 - 28 , 30 , 32 , 34 ], and 1 used a mixed methods approach [ 31 ].…”

“…All the included studies were conducted in either a hospital or a primary care center. Of the total number of studies, 7 were conducted in a hospital setting [ 24 - 27 , 29 , 32 , 33 ], 2 in a hospital and a primary care center [ 28 , 30 ], 1 in a primary care center [ 31 ], and another in a group of polyclinics [ 34 ].…”

Looking Behind the Curtain: Identifying Factors Contributing to Changes on Care Outcomes During a Large Commercial EHR Implementation

“…Although an increase in nursing staff led to decreased patient ratios, the ED was still less efficient overall because ED physicians faced a significant change moving from paper-based to electronic ordering. Such inefficiency following CPOE implementation has been extensively reported by previous studies [1819]. Most informants reported that appropriate training resources were available, but perceived that effective learning happens only with the use of the new system in the clinical environment.…”

Satisfaction with the newly-implemented Electronic System for Integrated Health Information among Pediatricians at a University Hospital

“…Although, many residents may adapt easily with the new EHR system as they were trained in variety of health system. Shriner et al found that majority of residents identified that overall availability of EHR resources are important factor when considering future employment opportunities [11]. However, the level of adoption of EHR systems is rapidly growing in Saudi hospitals, where in 2014, 50% of hospitals in Riyadh had a fully functional EHR system [13].…”

“…Another disadvantage highlighted by the healthcare providers is the inputting information in the EHR, it can take up to several hours entering the data after seeing the patients, this where the physicians feel themselves as a well-paid data entry clerks [10,11] The free standing children hospitals face a unique barrier. Ronald et al found that among 2794 (H) in US.…”