Computerized physician order entry more commonly referred to as CPOE, has been around for more than a few years.  The success or failure of CPOE being implemented in a Hospital or practice successfully depends on; well, everybody.

It’s not just the technician or consultant hired to build the orders or the order sets that will make it a success or failure. It takes an entire team to make it succeed or fail.

There is one way for sure to make sure your CPOE implantation fails. Just hire someone and say make it happen. If you don’t involve administration, physicians, nurses, staff, radiology, laboratory and ancillary departments, then you will fail.

** You need a good representation from each group to consider the impact CPOE has on the workflow and health care process for each group.

To quote a line from the movie Apollo 13 “Failure is not an option.”

How do you avoid failure with such a huge undertaking? It’s really simple; you start with leadership and make a plan. Discuss all your options, and do not include failure as being one of them.

Three considerations for a successful CPOE implementation.

1. Leadership Involvement
   a) Radiology
   b) Laboratory
   c) Physicians
   d) Administration
   e) IS/IT department
   f) Nurses
   g) Medical Assistants
   h) Front Office staff
2. Realistic requirements/goals
   a) Workflow
   b) Training/Time
   c) Build of Order Sets
   d) Support
3. Plan
   a) SDLC/Project Plan
   b) Pre-implementation (testing, education, set up, build)
   c) Implementation (education, support)
   d) Post-implementation (education, support, lessons learned, fine-tuning orders and order sets)

Of the considerations and supporting information the one to be emphasized most is testing, testing and testing.

Test until you cannot test anymore and then test it 3 more times.  This will alleviate many problems for end users and frustration levels.  It helps with the acceptance of the “new software” and negates the old way was better mentality.

Once you have successfully rolled out your CPOE, you will reap many benefits.  Nurses and staff will no longer have to stop working to try locating medical records or results that have been faxed over. They will not have to interpret the orders that have been hand written.

Your physicians will have the ease of signing the orders and viewing results on the computer or their own personal electronic device.  They won’t have to stop and look for that old prescription pad.

Administration will no longer have to order prescription pads or pads of paper with order sets printed on them. You will have a savings on paper products as well as storage space for all those old paper orders.  Look at that we just saved a few acres of trees with implementing just one module successfully.

One of the major keys to success is having the lab and radiology and other ancillary departments involved from the start….  It will mean interfacing with various systems…. No small task.

Caution should be applied though. You should always build in redundancy to any system you implement.  You have to have a backup system in place for that inevitable act of Mother Nature or Murphy’s Law.