Quality Outranks Financial Considerations in Order Set Utilization

March 1, 2010--When it comes to order set utilization, financial drivers take a backseat to improved quality, safety and compliance, according to the findings of an independent national survey of hospital clinical and IT executives and C-level administrators released today at HIMSS10. The survey, conducted on behalf of Wolters Kluwer Health (Booth #5501), was designed to measure the prevalence and utilization patterns of, and satisfaction with, order sets and electronic order set solutions.

Eighty six percent of participating hospitals utilized order sets. Of those, 62 percent used paper-based order sets, including 83 percent who were actively considering the purchase of an electronic solution. Thirty eight percent used an electronic order set solution, two-thirds of which were integrated with CPOE/EMR.

Regardless of the order set environment, enhanced quality (54.9%) was the leading driver of order set usage, followed by advancing the practice of evidence-based medicine (52.8%), increased safety (49.5%) and improved compliance (45.7%). Financial drivers, including cost reductions (11.5%) and eligibility for stimulus funding (3.8%) ranked lowest.

"Eligibility for stimulus funds is a priority, but it is not driving hospitals' decisions regarding the use of evidence-based order sets," said Arvind Subramanian, President & CEO, Wolters Kluwer Health Clinical Solutions. "Instead, their focus is on quality and safety. They also place a much higher value on ease-of-use and the ability to integrate with CPOE than on price."

Among respondents utilizing an electronic order set solution, more than 56 percent indicated that integration with CPOE/EMR was a significant factor in their purchasing decision, followed by ease-of-use (47.4%). Price was ranked as significant by just 29.8 percent of respondents in this group.

Of those considering the purchase of an order set solution, ability to integrate was a significant consideration for 59.3 percent, followed by price (57.7%) and ease-of-use (56.5%).

All electronic order set solution users were unanimous in their rankings of clinical and administrative benefits, although those with integrated solutions ranked key benefits higher:

• Top clinical benefits: Standardized care processes (85% among integrated and 67.9% among non-integrated users); enhanced quality and safety (81.7% and 51.8%, respectively); and fewer complications and/or adverse events (40% and 32.1%)
• Top administrative benefits: Increased regulatory compliance (60% among integrated and 46.4% among non-integrated users); more efficient monitoring (56.5% and 37.5%); and higher physician satisfaction rates (40.9% and 28.6%)

"Though evidence-based order sets integrated with CPOE or EMR is the holy grail of advanced point-of-care clinical decision support, non-integrated users can still realize significant benefits from order set solution," said Subramanian. "That is why ProVation® Order Sets, powered by UpToDate® Decision Support, on its own is a powerful tool for advancing the practice of evidence-based medicine. But it is also easily integrated with any facility or vendor clinical information system."

ProVation Order Sets [1] is an easily customizable order set authoring and management solution that provides flexible integration into clinical processes to streamline the delivery of standardized care for improved patient safety, outcomes, clinician performance and regulatory compliance. Built upon ProVation Medical's award-winning, clinician-designed technology platform, ProVation Order Sets offer automatic linking to the superior clinical decision support content of UpToDate, the resource of choice for more than 360,000 clinicians.

UpToDate [2] covers more than 7,700 topics in 15 medical specialties and includes more than 80,000 pages of text and graphics, as well as links to Medline abstracts, more than 260,000 references and a drug database. Content is continuously reviewed and updated by physician editors and authors.

In addition to integrated links to UpToDate, ProVation Order Sets offer the flexibility to link additional clinical resources based upon client needs and preferences. To help facilities achieve the highest possible degree of automation, ProVation Order Sets feature vendor-neutral mapping and export capabilities that allow for flexible integration into any facility or vendor EMR or CPOE system.

The online survey, conducted by Diligence Analytics Dec. 15, 2009-Jan. 7, 2010, was completed by 705 hospital-based clinical and IT executives and C-level administrators.

About Wolters Kluwer Health

Wolters Kluwer Health (Philadelphia, PA) is a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health and pharmacy. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins [3] and Facts & Comparisons^® [4]; and electronic information providers, such as Ovid^® [5], UpToDate^® [6], Medi-Span^® [7] and ProVation^® Medical [8].

Wolters Kluwer Health [9] is part of Wolters Kluwer [10], a leading global information services and publishing company. The company provides products and services for professionals in the health, tax, accounting, corporate, financial services, legal, and regulatory sectors. Wolters Kluwer had 2008 annual revenues of €3.4 billion ($4.9 billion), employs approximately 20,000 people worldwide, and maintains operations in over 35 countries across Europe, North America, Asia Pacific, and Latin America. Wolters Kluwer is headquartered in Alphen aan den Rijn, the Netherlands. Its shares are quoted on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Visit www.wolterskluwer.com [11] for information about our market positions, customers, brands, and organization.