Earlier this year members of the Office of the National Coordinator for Health Information Technology (ONC) pointed to the abundance of published research demonstrating the positive influence of the EHR Incentive Programs and their meaningful use requirements on care quality, safety, and efficiency. One significant takeaway from this literature review was strong evidence supporting the favorable effects of computerized physician order entry (CPOE) on patient outcomes.
With CPOE a cornerstone of the EHR Incentive Programs and its role increasing in future stages of meaningful use, how is CPOE adoption going to evolve over time? That was one of the questions posted to Methodist Health System’s SVP and CMIO/Chief Quality Officer Sam Bagchi, MD, during a sitdown interview at Wolters Kluwer booth at HIMSS14 in Orlando.
In this second and final installment of a two-part CPOE Q&A, Bagchi describes what lies ahead for his health system as it moves forward with CPOE and looks to increase adoption and improve the functionality of this health IT tool. As he explains, getting physicians to adopt CPOE is a necessary first step, but it is only the beginning of an ongoing process of optimization.
What’s next for CPOE at Methodist Health System?
We’re seeing a lot of organizations, ourselves included, running into high-adoption CPOE projects because of various deadlines that are out there and initiatives that are related to this. As we look back, we see people sometimes unhappy with how the system works or how their content is organized.
Our key in the first phase is getting physicians into the system, comfortable with the content, and generally standardizing evidence-based elements. The key to the optimization phase is comparing similar content and refining our content so that we only have one heart failure order set and four heart failure order sets at hospitals, so that it’s easier to find what you need and that we can count on getting the right care to the right patient at the right time every time.
What kind of input are you getting from physicians and how do you turn feedback both positive and negative into CPOE improvements?
We take every complaint as a request for improvement. We take input from all the physicians. We set up email addresses and we have frontline staff out at the hospitals soliciting feedback. We use our training sessions as feedback sessions so we’re not just telling you how it is today is how it has to be but we want to know what you want to improve. We take that feedback to an integrated informatics IT change management meeting that happens once a week that didn’t exist last year and now exists so that we can organize our changes, be aware of our changes, and rapidly improve our current system.
How does this approach to soliciting feedback and rolling out enhancements also work to benefit the organization’s health IT systems and services?
It also helps us deploy innovations or new elements of the enterprise EMR that we want to use and not wait two to three months to do it. We’re doing 50-60 changes a month based now on this process, and if you don’t listen and move quickly after you go live on a project like CPOE, your physicians that you have engaged so heavily to get there can sometimes get off the bus. So we’re trying to keep everybody on the bus.
Read the first part of this interview here.
