Safety net providers: CPOE adoption needs leadership, med staff buy-in

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Transitioning safety net providers to computerized physician order entry is a challenge, but goes more smoothly with commitment from a facility's governing body and physicians, according to two providers who have lived through the experience.

"It's not just teaching CPOE. It's also teaching basic computer competence," according to Sean Folweiler, product manager of Fresno, Calif.-based Central Valley Collaborative, said during a webinar held Dec. 14 by the Department of Health & Human Services' Health Resources and Services Administration. Many clinicians in Folweiler's health system--which includes five Federally Qualified Health Centers--needed to be taught how to log on to computers, create passwords, and use Windows shortcuts.

Loss of productivity during such transitions can also be a major challenge, since safety net providers are disproportionately affected. "Any slowdown is very detrimental to us," said Robbie Dewberry, CEO of Mitchell County Hospital District in Colorado City, Texas, which operates a 25-bed critical access hospital and related facilities. There are four physicians on staff.

Dewberry recommended that hospitals, especially safety net providers, first must get a commitment to CPOE and electronic health record systems from key leadership in decision-making, and have accurate information available to validate their concerns.

"That way you have buy-in, which is important to deal with obstacles you may run into," Dewberry explained.

He also recommended that the hospital develop an executive team to manage the transition, communicate with providers, and commit resources to education and assistance. For example, his facility has a computer "super-user" accompany the physicians on rounds to help them with CPOE.

A study published in September in the Journal of the American Medical Informatics Association found CPOE to be one of the biggest obstacles to meeting the Meaningful Use requirements.

"You can do it, your staff can do it and your patient population will benefit," Folweiler said.

To learn more:
- access the presentation slides
- read the study abstract

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