What is CPOE? CPOE is computerized physician order entry. This is relatively a new paradigm shift in the past decade where more and more hospitals are converting to having prescribers enter medication orders within EHR (electronic health record) systems. Many hospitals in this country still do not have CPOE functionality, however this is slowly changing. Formerly, and still in many hospitals, medication order are written in the paper medical record or chart where a nurse is tasked to make a copy and send it to the pharmacy departments to process. This could be done via telephone or verbal orders, copies of written orders sent, scanned, tubed, or faxed to the pharmacy. This could cause time delay and communication problems in between if there are steps missing such as lost orders, paper james, technical issues, or if the written instructions are illegible on paper or incoherent on the phone. Obviously this is a potential problem due to errors that could occur and delay in treatment in order to resolve the errors. In pharmacy for example, nurses scan copies of physician orders via the fax or expensive technological scanning systems. Pharmacists will then have to transcribe the same orders into the pharmacy information system. This duplication of work obviously is a burden on time depending the volume of patients in the hospital and the number of orders to be processed per patient. Rather than spending time that could be used in reviewing important clinical data, written orders sometimes are illegible and require the pharmacist to track down the prescriber by phone or pager.
CPOE is a mechanism where prescribers will begin entering orders for what used to be done on paper. Some of the challenges in this shift is the need for training on how to use the hospital’s EHR system, and the nuances involved with order entry for all types of patient orders. Older prescribers who are not prone to change will need to start adapting to this new practice. Many physicians who also work in other private practices and other healthcare institutions may overwhelmed trying to learn several different EHR systems. To circumvent issues, ‘order sets’ are usually created for them. These are a collective set of orders that could be ordered quickly pertaining to a certain diagnosis, procedure, protocol, or condition. Each order in an orderset will have a checkbox for the physicians to check or not to check so that orders could be quickly entered without having to type everything in. Another option seen in some hospitals is where prescribers ask the clinical pharmacists or nurses to enter on behalf of them. In this method, any orders not entered a prescriber will route to the prescribers account for them to acknowledge and sign when they have time to review them.
As EHR systems roll out to more hospitals, many older practices will become obsolete. Physician order entry will streamline many processes and cut down on communication errors. Pharmacists will not have to duplicate order entry and could focus more time on reviewing patient medication orders to ensure better safety and accuracy.