Unintended consequences of computerized physician order entry implementation

Computerized Physician Order Entry (CPOE) systems are essential towards the improvement of the ordering processes within the health centers or hospitals. These systems are also valuable in relation to improvement of patient safety and enhancement of the quality of care or service delivery (Cohen A, et al., 2005). This is an indication that the systems are vital in the achievement of quality services with reference to quality care of patients within the health centers. Despite these benefits, there are unintended consequences in association with the implementation of the CPOE systems within the context of the hospitals or health centers (Kaushal et al., 2003). The main objective of this research analysis paper is to evaluate three critical forms of unintended consequences in relation to the implementation of CPOE systems in hospitals.

More/New Work for the Clinicians

Clear identification of the unintended consequence

One of the types of unintended consequences in relation to the implementation of CPOE systems in the modern hospitals is the generation of more or new work for the clinical and non-clinical staff (Ash, Berg, & Coiera, 2004). CPOE implementation goal is to offer a better patient overview to the clinicians. Despite the essence of this direct goal and plan, implementation of the CPOE systems generate more work in the provision of better patient overview to the clinicians. This increases the volume of work or overview in comparison to the previous methodology prior to the implementation of the CPOE systems in the hospitals.

How and/or why the unintended consequence occur

Implementation of the CPOE systems in the hospitals have various capabilities to lead to generation of new or more works to the clinical and non-clinical staff. Some of ways for the development of this unintended consequence within the hospital include entering of new information not previous required such as justification of treatment selection and response to excessive alerts containing unhelpful information. Expansion of extra time for the completion of non-routine and complex orders might also contribute to the realization of this unintended consequence.

What threat to patient safety occurs with each consequence identified?

The unintended consequence slows down effectiveness and efficiency in the service delivery thus hindering the provision of quality services and care to patients. Implementation of the systems slows down documentation and ordering processes thus affecting the safety of the patients especially those in critical conditions. There is also minimal attention to the patients because of the increase in the volume of work by the clinical and non-clinical staff.

What ethical, legal or social issue may be related to this consequence?

One of the social issues relating to this consequence is discrimination to the clinical staff in the process of delivery services to patients. This relates to the aspect of non-specific medication interactions not concerning the current patient.

How would the consequence or remedied be handled

Loss of efficiency takes time to facilitate the achievement of the health centers in relation to enhance patient overview to the clinicians. In order to handle this consequence, training and development of the users should be mandatory and attention away from demanding schedules.

Section 2: Generation of New Kinds of Errors

Clear identification of the unintended consequence

Implementation of the CPOE can generate new kinds of health care related errors (Ash, Berg, & Coiera, 2004). This is an indication that CPOE systems have the ability to prevent and cause medication errors. These new medical errors hinder the realization of the goals and objectives of the hospitals towards the provision of quality health care to patients. The main objective of the implementation of these systems is to eliminate medical errors in relation to documentation and ordering. In the implementation of these systems, there emerges an unintended consequence in the form of errors.

How and/or why the unintended consequence occur

Implementation of the CPOE systems within the context of hospitals can cause or generate new medication or health-related errors. Some of the sources of the new CPOE-related errors include confusion in relation to order presentation and selection options, inadequate or inappropriate text entries, and misunderstandings in relation to training, test, and generation of versions of the system. Another source of this consequence is the concept of the workflow process mismatch. It is also critical to note that system designs and confusion of the users in relation to functionality also generate new forms of errors.

What threat to patient safety occurs with each consequence identified?

Generation of new errors can affect documentation or ordering process thus interfering with confidential information regarding current and future patients. This confusion arising from functionalities of the system would expose confidential information of the patients thus essence of unethical practices within the health system.

What ethical, legal or social issue may be related to this consequence?

In case of confusion in the data entry or documentation of valuable or confidential information relating to the patient, there can be an invasion of privacy thus unethical practice towards enhancing safety of the patient. There is also lack of efficiency in the service delivery hence hindering the realization of the goals and objectives of quality health services.

How would the consequence or remedied be handled

In order to eliminate or minimize this consequence, it is vital for users to undergo effective and efficient training process for the purposes of familiarizing with the functionalities of the systems. Training will ensure that users have valuable ability to operate various versions of the systems, enter appropriate texts, and adopt accurate selection/presentation options.

Section 3: Overdependence on Technology

Clear identification of the unintended consequence

Another unintended consequence of implementation of the concept of CPOE systems is overdependence on technology (Ash, Berg, & Coiera, 2004). This is because CPOE technology has the ability to diffuse and entrench itself within the organization. This makes it indispensable in relation to the clinical care delivery. There is havoc situation when there are no paper backup systems to sustain the system failures. It is also ideal to note that clinical staff forgets to utilize paper work when the systems are off thus the essence of over dependency on technology as an unintended consequence following the implementation of the CPOE systems in hospitals.

What threat to patient safety occurs with each consequence identified?

System failures within the organization would hinder the provision of quality services to patients. This is because clinical staff would have troubles remembering appropriate dosages and recommendations in case of overdependence and application of this technology within the context of the hospital. This indicates that hospitals experiencing this unintended consequence will offer low quality services to consumers when CPOE systems fail to operate effectively and efficiently.

What ethical, legal or social issue may be related to this consequence?

Application of these systems focuses on the personification of technology to perform the roles of clinicians in relation to appropriate dosages and recommendations. This indicates that technology plays a critical role in shaping operations within the context of health sector and centers. Human beings (clinicians) should portray moral aspects through offering valuable decisions with minimal influence of technology.

How would the consequence or remedied be handled

In order to handle this unintended consequence, the organization should focus on the presentation of diverse options with reference to documentation and ordering processes and activities. This will contribute towards minimization of overdependence on technology with the purpose of offering quality services to patients. In case of failure of the CPOE systems, the organization would have the opportunity to continue its operations through alternative means towards the realization of the goals and objectives such as quality health to patients.