Computerized Physician Order Entry (CPOE)

Most people would agree that if 2005 was "the year" of anything, it was the year of the electronic medical record (EMR). This was the year health information technology finally went mainstream, in the public consciousness, following last year's announcement of a national strategy. David Brailer led the push to back EMRs and data exchange. Pilots were announced with some limited federal funding, and regional health information organizations (RHIO) proliferated. You could even argue that …

Regular readers of FierceHealthcare know that I put a lot of stock in Mr. HISTalk's opinions. A hospital IT director with a great deal of experience in the health IT field, Mr. HISTalk has a lot to say and usually says it very eloquently. This week he takes on a controversial topic, namely assigning blame for CPOE failures, a topic what has gathered a fair amount of publicity over the past month. So, who should we blame for poor outcomes when CPOE systems are implemented--vendors or hospitals? Blog

There is little doubt that the big story in health IT circles continues to be the CPOE study in Pediatrics which found an alarming increase in mortality rates at Children's Hospital of Pittsburgh. Those conclusions generated a fierce debate as to whether we need CPOE systems, and whether EMRs can be adapted for critical patient care situations. Yesterday, leading patient …

Patient safety experts convened in San Francisco, where some of the latest technologies were on view. While the now-controversial growth of CPOE was a hot topic of discussion, it does appear as though patient and equipment tracking is a problem which has found a solution. Christiana Care Health System in Delaware has totally "tagged" its staff, equipment and patients in its ER. As a result, there has been a huge improvement in productivity as well as staff satisfaction and lowered …

A study published in the Journal of the American Medical Association asks if enough is being done to avoid medical errors. The study, led by Daniel Longo of the University of Missouri-Columbia, looked at policies at all acute care facilities in Utah and Missouri in 2002 and 2004. Researchers found that only 3 percent of hospitals have policies in place that require doctors to order prescriptions using CPOE systems. That in itself isn't unusual. On the other hand, some of the …

In the wake of last week's much discussed report on CPOE errors in Pediatrics, some voices are wondering if there should be some form of regulation for CPOEs. Is it time for a debate on the issue? The author of the Pediatrics study comments in an interview with UPI: "Drugs or medical devices must go through some degree of inspection and evaluation to determine whether the manufacturer's claims are substantiated. There's no such process for medical software …

This week I heard a very bitter physician complaining that using an electronic medical record got between him and caring for his patients, and imposed secretarial tasks on him. Then on Tuesday we got perhaps the most negative news yet about a problematic CPOE installation at Childrens' Hospital in Pittsburgh, where after its introduction patient mortality increased. There was also …

A study in the December issue of Pediatrics linking the introduction of a CPOE systems with an increase in mortality rates at Pittsburgh Children's Hospital is getting considerable attention. Researchers uncovered what appeared to be a significant spike in mortality rates for patients at the hospital, which uses Cerner's Millennium CPOE software. It appears that the process, which was used for CPOE in the intensive care unit (ICU), had some serious flaws; but it also …

Following yesterday's news that a CPOE system from Cerner was tied to an increase in patient mortality rates, there was more bad news for electronic medical record vendors today. Arizona-based Navapache Regional Medical Center said it will not continue a trial of the Emergisoft EMR it started last December in its emergency department. The hospital is going back to scanning paper records. That, the hospital says, is as electronic as it wants to be for now. "Emergisoft's weak point was its …

> A day after a major study in the journal Pediatrics found an increase in mortality rates associated with one of its CPOE implementation, a dueling study sponsored by Cerner finds the exact opposite. Release

> Disease management specialist American Healthways says it has outgrown its existing headquarters and is moving to a larger …