Hospital IT execs: Patient safety results should define CPOE success

The success of a computerized physician order entry implementation project should be defined by improvements to patient safety, according to Chris Snyder, a hospitalist and chief medical information officer at Peninsula Regional Medical Center, a 288-bed acute-care facility in Salisbury, Maryland.

Snyder (pictured right), who spoke on the recent FierceHealthIT webinar "Boosting physician adoption of CPOE to maximize its benefits," said that while adoption is challenging, it ultimately opens up doors for stronger governance structures. That, in turn, leads to faster decision-making, which boosts the quality of patient care, he said.

"The speed of it is remarkable," said Snyder, whose rural facility first implemented CPOE 10 years ago and is about to make another transition. "The capability to visualize information and to stop the Swiss-cheese model before it gets to the pharmacy--before it gets to the nurse and definitely before it gets to the patient--has shown to be enormous at our institution."

Snyder talked about how CPOE helped get providers on the same page when ordering medications, including anticoagulation medications and the narcotic Dilaudid. Snyder and Peninsula used CPOE to develop a "funneled approach" to ordering.

"It turned out to be a huge stabilizer in the variability of ordering practices," Snyder said. "We weren't following guidelines ... and we weren't managing the protocols the way we should have been. ... It stopped us from creating errors with overprescribing."

James Bender (pictured left), director of health information at Seattle-based Virginia Mason Medical Center, echoed Snyder's sentiments about the difficulty of adoption, comparing it to inviting providers to drive in London.

"Initially when you turn this product on ... it just doesn't feel right," Bender said. "These tools are clearly disruptive to how we think."

Still, he said, use of CPOE--which the 350-bed hospital also implemented a decade ago--has helped to reduce waste by making once invisible care processes more visible. Currently, according to Bender, Virginia Mason is in the process of rolling out CPOE technology across its seven clinics, which employ 450 providers.

Bender added that a vital step to successful implementation is knowing how to explain the journey to staff.

"Know your elevator speech," Bender said. "We need to be very clear about why we're doing this ... at the end of the day, we've got to have an answer for our people that resonates with why they're here."

Snyder agreed.

"I had doctors when I first started say 'I don't believe this is safe,'" he said. "I set out on journeys to prove to them that [CPOE] was safer."

For more:
- listen and watch the full webinar, available on-demand for free

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