CSC consultants: CPOE implementation doesn't have to take years

When the employer-centric Leapfrog Group started way back in 2000, it pushed computerized physician order entry as a way to improve the quality of care. (The impetus likely was the landmark 1999 Institute of Medicine report, To Err Is Human.) Few hospitals scored very high on the Leapfrog Group's report cards.

With the advent of the American Recovery and Reinvestment Act, CPOE is again in the spotlight, since it's one of the key components of the proposed requirements for meaningful use of EMRs. For Stage 1 of meaningful use, which runs through 2012, hospitals will have to enter 10 percent of their orders electronically, while the CPOE threshold for physicians is 80 percent, based on the current proposal.

Time may be fairly short, but meeting the CPOE requirement is possible, according to CSC consultants Jane Metzger and Donna Schmidt. "A successful implementation requires the right reason [better, safer care for patients], the right policy [the only way orders are managed in the hospital] and the right understanding of the challenge [transforming the complex order management process]," the two state in the just-published April issue of Hospitals & Health Networks. Pressure from payers, they say, is not the right reason.

"CPOE success stories all share an executive team and corporate culture pushing for more consistent evidence-based care and for safer, more reliable processes; CPOE enables a new, standard process to achieve that vision. Voluntary use of CPOE by physicians or any other professionals is not an option," they add.

Metzger and Schmidt debunk a widely held belief that CPOE implementation in an average hospital takes three to five years. "A growing number of examples prove otherwise," they write. "In one recent case, a smooth implementation was accomplished in 15 months from the beginning of planning to physician entry of 92 percent of orders throughout the hospital." Keys to quick success include understanding of workflow issues and leadership from clinical teams.

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