CPOE adoption up, but most hospitals still lack capability

Despite a rise in the number of hospitals implementing computerized physician order entry (CPOE) since the government launched its incentive program for electronic health record adoption two years ago, a majority of hospitals still aren't using this technology.

In a new report, KLAS, the Orem, Utah-based research firm, found that 21.7 percent of hospitals had CPOE systems in 2010. That represents a steep rise from the 15.7 percent that had it in 2009. In 2008, just 12.5 percent of facilities had CPOE, according to KLAS.

"As Stage 1 meaningful use deadlines approach, more and more hospitals and clinics are adopting CPOE," said Jason Hess, author of the report. "Reviewing eight consecutive years of KLAS research on CPOE adoption, we see that before ARRA, an average of 87 hospitals went live with CPOE each year; since ARRA passed, that average has jumped to 233 per year."

Nevertheless, nearly 80 percent of hospitals still lacked CPOE a year ago. Considering how long it takes to implement these complex systems, CPOE remains a big hurdle for many facilities that hope to show Meaningful Use by the end of 2012.

Cerner and Epic are the leading CPOE vendors, KLAS reports. The largest number of hospitals that have installed CPOE are using Cerner's Millennium Power Chart. On average, 81 percent of the orders in facilities that have gone live on Cerner Millennium since 2009 are being entered in CPOE. Of the orders entered in hospitals that use Epic, 83 percent are going into the computerized system.

McKesson's Horizon system rose from 37 to 90 CPOE installations at the end of 2010, with a 45 percent adoption rate, KLAS says. Eleven hospitals adopted the same company's new Paragon system, with a 25 percent adoption rate so far. The number of Meditech's live C/S CPOE sites has "doubled," according to KLAS, but no figures are given. Thirty-one hospitals went live on Siemens' Soarian CPOE system in 2010.

Also ranked were Allscripts' Sunrise Clinical Manager, an early CPOE leader that has fallen behind in recent years, according to KLAS; and GE Healthcare and QuadraMed, which have added only a few new sites. A less well-known vendor, CPSI, has increased its number of CPOE sites from 30 to 67 since 2009. 

To learn more:
- read the KLAS press release
- see the Meaningful Use criterion for CPOE