The Costs and Benefits of Computerized Physician Order Entry (CPOE)

Computerized Physician Order Entry is a process by which physicians can place orders regarding patient care through an electronic system which communicates them to the various departments. They commonly include medication orders to the pharmacy, lab tests for blood work, radiology orders and other instructions relating to patients.

CPOE is commonly used with e-prescribing systems which are able to alert doctors to potential drug-drug or drug-allergy interactions with a particular order. Stage I of the MU program emphasized the use of CPOE and e-prescriptions and most practices have implemented these two modules-at a minimum-even if they have not purchased a full-fledged EHR. CPOE is not just a replacement for paper charts and involves a complete redesign of the complex order entry process.

CPOE has many benefits for both practices and patients:

● Patient charts are not misplaced or misfiled
● Reduce handwriting and miscommunication errors with order entry
● Improve patient care with clinical decision support systems
● Decrease cost of ordering
● Comprehensive case documentation and medical history of patient
● Improve communication between various departments such as lab assistants, doctors, nurses, specialists etc.

Of the above list, perhaps the most visible are the time savings and efficiency improvements. Clear and legible electronic orders do not need further clarifications and leave no room for interpretation. Order recipients do not have to interrupt the prescribing doctor’s workflow which dramatically raises the probability of errors. There is also a substantial reduction in the time taken to place orders as well as receive results from the laboratories or medications from the pharmacy.
Though the advantages are many, organizations have been slow to adopt CPOE systems due to the substantial costs in terms of both money and technology resources. Order entry systems for large hospitals can cost several million dollars and a thorough analysis of organizational processes has to be undertaken before implementing them. Even after the systems are installed, employees need extensive training and support in order to become proficient with the new applications.

CPOE systems have more impact when they are integrated with other computer applications within the organization such as EHRs, practice management tools and E-prescribing modules. Interoperability, privacy and security issues as well as data sharing capabilities between various medical software are prime concerns and implementation of CPOE. In spite of these ongoing challenges, most healthcare providers have implemented it partly due to the meaningful use program.