Implementation Of Computerized Physician Order Entry In Seven Countries

Abstract

We review the extent and functionality of computerized physician order entry (CPOE) systems in seven Western countries. We compare nations' implementation levels; linkages with other health care information technologies; amount and types of use by clinicians; drivers of implementation; inclusion of decision-support systems and electronic medical records; and goals (for example, patient safety and efficiency). Implementation of CPOE is slower and more problematic than anticipated (adoption rates are 20 percent or less) and often poorly integrated, inducing new errors and generating frustration with user interfaces and repetitive tasks. Nevertheless, the advantages of CPOE remain compelling.

The Challenges of Implementing Packaged Hospital Electronic Prescribing and Medicine Administration Systems in UK Hospitals: Premature Purchase of Immature Solutions?

“…This echoes elements of previous UK experience with CAPM/ERP systems. We infer that, although policy incentives can be effective in achieving adoption (Aarts and Koppel 2009), they may also have accelerated premature purchase of immature solutions. This suggests a need for a gradual move in the market for such immature technology.…”

“…However, standard COTS solutions, built around generic models of the user organisation, may be far removed from the workflows of particular adopter organisations, necessitating a considerable effort to configure and customise software or to adjust local working practices (Pollock and Williams 2008). Despite these investments, the HEPMA market in England is faced with a great deal of uncertainty and is undergoing rapid change and evolution (Aarts and Koppel 2009;Mozaffar et al 2014). As well as intense policy pressures and incentives to adopt HEPMA, hospitals are confronted by the lack of maturity of current supplier offerings, their limited tailoring to the English context, the diversity of systems and lack of knowledge about the available options.…”

“…Stakeholders managing health systems in many countries have invested substantial efforts to implement and deploy electronic or ePrescribing systems (Mozaffar et al 2014;Cresswell et al 2013) to support prescribing decisions in health organisations (Aarts and Koppel 2009;Bates et al 1998). The National Health Service (NHS) in England has similarly invested considerable resources in these systems.…”

Reliability of a point‐based VTE risk assessment tool in the hands of medical residents

“…Most alert systems require hospitals to have computerized order entry, which has achieved only 20% market penetration in US hospitals. 40,41 Therefore, some FIGURE 2. Strategies for improving adherence to clinical guidelines for venous thromboembolic events (VTE).…”

Physician satisfaction with transition from CPOE to paper-based prescription

“…In practice, it reduces preventable adverse drug events [2]. While implementation of CPOE in hospitals in the USA [3] [4] and in the Netherlands seems to be well underway, other countries lag far behind [5]. In the United Kingdom, vendors and adopters lack an understanding of how to design and implement generic solutions to meet diverse user needs [6].…”