Software Application Process for a Clinician Provider Order Entry (CPOE) system
Software Application Process
Clinician Provider Order Entry (CPOE) System
The planning, customization, launch and continued use of a Clinician Provider Order Entry (CPOE) system in a local hospital forms the foundation of this analysis. The processes being used prior to the systems' planning and implementation are detailed to provide a basis of comparison of system contribution and performance. A timeline of the decision makers involved in the process, how and where they identified vulnerabilities in the system and the software selection process are also detailed. The CPOE system today on average handles over 10,000 queries and has resulted in a 78% reduction in order entry errors with a corresponding reduction in costs. Most importantly, it has drastically improved the healthcare providers' effectiveness in treating patients while also augmenting the entire patient experience more positively.
Analysis of CPOE Substitute Processes Prior To System Implementation
The series of processes and systems that had been in place prior to the CPOE system were manually based, required continual updates and manually recursive checks of accuracy. They also had very steep learning curves for those new employees, from nurses and healthcare providers to administrators to learn and use. The manually-based system had processes in place that were only oriented towards one department as well, and had to have more manually-based modifications to be used in advanced treatment areas incouding cardiology. On top of all these other factors, the manually-based CPOE system had manually-based approaches to filing for reimbursements and managing the more complex order entry and order management functions in conjunction with the leading insurance providers. Manually-based approaches to order management, transaction management and distributed order entry can cost a healthcare provider hours of administrative time and hundreds of thousands of dollars in error-field orders and misplaced and incorrectly submitted orders (Lykowski, Mahoney, 2004). The previous systems also lacked any form of analytics or reporting as to their...
The weakness of manual systems is their inability to create an effective, measurable baseline of performance which can be used for evaluating and improving performance over time (Purbey, Mukherjee, Bhar, 2007).
Timeline and Decision Marker Analysis of the CPOE System Implementation
The following is the timeline provides insights into how a local hospital chose to analyze and act on the inefficiencies of their CPOE process and manually-based systems. Two years ago, in 2010, losses from incomplete and inaccurate CPOE processes lead to the local hospital taking a one-time charge of $667,000 and as write-down in non-recoverable Accounts Parable of an additional $122,000. In June, 2010 the Chief Financial Officer, Chief Operating Officer and Chief Information Officer met to review why such a large loss had been incurred. The group created a task force to investigate how it had occurred. Their report was due August 1, 2010. Included in the task force were experts in value stream mapping, business process management (BPM) and experts in distributed order management systems from a local system integration partner.
On August 1, 2010 the task force presented their findings. Included was an analysis of how the existing manual processes were inadequate for the volume and complexity of the workflows they were attempting to support. Physicians, administrative staff, nurses and medical specialists all were at the presentation. At the end of the task force results discussion, the CIO invited those using the system to also contribute their ideas of hwo the system could be improved.
This third phase of the timeline included intensive cross-functional meetings involving every member of the exiting CPOE process. These included representatives from the healthcare insurance providers who were often frustrated by the errors in the existing CPOE process. Also included were administrators, physicians and nurses who needed the system to do their jobs, in addition to key members of the IT staff including the CIO. The CIO acted as the project lead on…
