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Computerized Provider Order Entry Adoption: Implications for Clinical Workflow
ABSTRACT OBJECTIVE To identify and describe unintended adverse consequences related to clinical workflow when implementing or using computerized provider order entry (CPOE) systems. METHODS We analyzed qualitative data from field observations and formal interviews gathered over a three-year period a...
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| Published in: | Journal of general internal medicine : JGIM 2009-01, Vol.24 (1), p.21-26 |
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| Main Authors: | , , , , |
| Format: | Article |
| Language: | English |
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| container_end_page | 26 |
| container_issue | 1 |
| container_start_page | 21 |
| container_title | Journal of general internal medicine : JGIM |
| container_volume | 24 |
| creator | Campbell, Emily M. Guappone, Kenneth P. Sittig, Dean F. Dykstra, Richard H. Ash, Joan S. |
| description | ABSTRACT
OBJECTIVE
To identify and describe unintended adverse consequences related to clinical workflow when implementing or using computerized provider order entry (CPOE) systems.
METHODS
We analyzed qualitative data from field observations and formal interviews gathered over a three-year period at five hospitals in three organizations. Five multidisciplinary researchers worked together to identify themes related to the impacts of CPOE systems on clinical workflow.
RESULTS
CPOE systems can affect clinical work by 1) introducing or exposing human/computer interaction problems, 2) altering the pace, sequencing, and dynamics of clinical activities, 3) providing only partial support for the work activities of all types of clinical personnel, 4) reducing clinical situation awareness, and 5) poorly reflecting organizational policy and procedure.
CONCLUSIONS
As CPOE systems evolve, those involved must take care to mitigate the many unintended adverse effects these systems have on clinical workflow. Workflow issues resulting from CPOE can be mitigated by iteratively altering both clinical workflow and the CPOE system until a satisfactory fit is achieved. |
| doi_str_mv | 10.1007/s11606-008-0857-9 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2607519</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>66748970</sourcerecordid><originalsourceid>FETCH-LOGICAL-c497t-b1e86988257efea63df22850af604ff6c6c3deb9d950b52a7c8acc9ec56bd5713</originalsourceid><addsrcrecordid>eNp1kU9rFTEUxYNY7LP6AdzIINTd1Jtk8s-FUB5VC8W6UFyGTCapqTOTMZlpqZ_eDO_RquAmIbm_nHtuDkIvMJxgAPEmY8yB1wCyBslErR6hDWaE1bhR4jHagJRNLQVtDtHTnK8BMCVEPkGHWAEB1ZAN-rSNw7TMLoVfrqs-p3gTOpeqy7SuZ-Oc7qrTLk5ziOPb6nyY-mDNesiVj6na9mEsF331LaYfvo-3z9CBN312z_f7Efr6_uzL9mN9cfnhfHt6UdvibK5b7CRXUhImnHeG084XYwyM59B4zy23tHOt6hSDlhEjrDTWKmcZbzsmMD1C73a609IOrrOuODW9nlIYTLrT0QT9d2UM3_VVvNGEg2BYFYHXe4EUfy4uz3oI2bq-N6OLS9aci0YqAQV89Q94HZc0luG0IpTKRjJSILyDbIo5J-fvnWDQa1R6F5UuUek1Kr06ePnnCA8v9tkU4HgPmFz-2Ccz2pDvOYJlQ4GKwpEdl0tpvHLpweH_u_8GWlutdQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>923384852</pqid></control><display><type>article</type><title>Computerized Provider Order Entry Adoption: Implications for Clinical Workflow</title><source>Springer Nature</source><source>PubMed Central</source><creator>Campbell, Emily M. ; Guappone, Kenneth P. ; Sittig, Dean F. ; Dykstra, Richard H. ; Ash, Joan S.</creator><creatorcontrib>Campbell, Emily M. ; Guappone, Kenneth P. ; Sittig, Dean F. ; Dykstra, Richard H. ; Ash, Joan S.</creatorcontrib><description>ABSTRACT
OBJECTIVE
To identify and describe unintended adverse consequences related to clinical workflow when implementing or using computerized provider order entry (CPOE) systems.
METHODS
We analyzed qualitative data from field observations and formal interviews gathered over a three-year period at five hospitals in three organizations. Five multidisciplinary researchers worked together to identify themes related to the impacts of CPOE systems on clinical workflow.
RESULTS
CPOE systems can affect clinical work by 1) introducing or exposing human/computer interaction problems, 2) altering the pace, sequencing, and dynamics of clinical activities, 3) providing only partial support for the work activities of all types of clinical personnel, 4) reducing clinical situation awareness, and 5) poorly reflecting organizational policy and procedure.
CONCLUSIONS
As CPOE systems evolve, those involved must take care to mitigate the many unintended adverse effects these systems have on clinical workflow. Workflow issues resulting from CPOE can be mitigated by iteratively altering both clinical workflow and the CPOE system until a satisfactory fit is achieved.</description><identifier>ISSN: 0884-8734</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-008-0857-9</identifier><identifier>PMID: 19020942</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Attitude of Health Personnel ; Attitude to Computers ; Biological and medical sciences ; Computerized physician order entry ; Delivery of Health Care - statistics & numerical data ; Delivery of Health Care - trends ; General aspects ; Health participants ; Hospitals ; Hospitals - statistics & numerical data ; Hospitals - trends ; Humans ; Information systems ; Internal Medicine ; Medical Order Entry Systems - statistics & numerical data ; Medical Order Entry Systems - trends ; Medical Records Systems, Computerized - statistics & numerical data ; Medical Records Systems, Computerized - trends ; Medical sciences ; Medicine ; Medicine & Public Health ; Miscellaneous ; Original ; Original Article ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Technology adoption ; User interface ; Workload</subject><ispartof>Journal of general internal medicine : JGIM, 2009-01, Vol.24 (1), p.21-26</ispartof><rights>Society of General Internal Medicine 2008</rights><rights>2009 INIST-CNRS</rights><rights>Society of General Internal Medicine 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c497t-b1e86988257efea63df22850af604ff6c6c3deb9d950b52a7c8acc9ec56bd5713</citedby><cites>FETCH-LOGICAL-c497t-b1e86988257efea63df22850af604ff6c6c3deb9d950b52a7c8acc9ec56bd5713</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607519/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607519/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21843037$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19020942$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Campbell, Emily M.</creatorcontrib><creatorcontrib>Guappone, Kenneth P.</creatorcontrib><creatorcontrib>Sittig, Dean F.</creatorcontrib><creatorcontrib>Dykstra, Richard H.</creatorcontrib><creatorcontrib>Ash, Joan S.</creatorcontrib><title>Computerized Provider Order Entry Adoption: Implications for Clinical Workflow</title><title>Journal of general internal medicine : JGIM</title><addtitle>J GEN INTERN MED</addtitle><addtitle>J Gen Intern Med</addtitle><description>ABSTRACT
OBJECTIVE
To identify and describe unintended adverse consequences related to clinical workflow when implementing or using computerized provider order entry (CPOE) systems.
METHODS
We analyzed qualitative data from field observations and formal interviews gathered over a three-year period at five hospitals in three organizations. Five multidisciplinary researchers worked together to identify themes related to the impacts of CPOE systems on clinical workflow.
RESULTS
CPOE systems can affect clinical work by 1) introducing or exposing human/computer interaction problems, 2) altering the pace, sequencing, and dynamics of clinical activities, 3) providing only partial support for the work activities of all types of clinical personnel, 4) reducing clinical situation awareness, and 5) poorly reflecting organizational policy and procedure.
CONCLUSIONS
As CPOE systems evolve, those involved must take care to mitigate the many unintended adverse effects these systems have on clinical workflow. Workflow issues resulting from CPOE can be mitigated by iteratively altering both clinical workflow and the CPOE system until a satisfactory fit is achieved.</description><subject>Attitude of Health Personnel</subject><subject>Attitude to Computers</subject><subject>Biological and medical sciences</subject><subject>Computerized physician order entry</subject><subject>Delivery of Health Care - statistics & numerical data</subject><subject>Delivery of Health Care - trends</subject><subject>General aspects</subject><subject>Health participants</subject><subject>Hospitals</subject><subject>Hospitals - statistics & numerical data</subject><subject>Hospitals - trends</subject><subject>Humans</subject><subject>Information systems</subject><subject>Internal Medicine</subject><subject>Medical Order Entry Systems - statistics & numerical data</subject><subject>Medical Order Entry Systems - trends</subject><subject>Medical Records Systems, Computerized - statistics & numerical data</subject><subject>Medical Records Systems, Computerized - trends</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Miscellaneous</subject><subject>Original</subject><subject>Original Article</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Technology adoption</subject><subject>User interface</subject><subject>Workload</subject><issn>0884-8734</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNp1kU9rFTEUxYNY7LP6AdzIINTd1Jtk8s-FUB5VC8W6UFyGTCapqTOTMZlpqZ_eDO_RquAmIbm_nHtuDkIvMJxgAPEmY8yB1wCyBslErR6hDWaE1bhR4jHagJRNLQVtDtHTnK8BMCVEPkGHWAEB1ZAN-rSNw7TMLoVfrqs-p3gTOpeqy7SuZ-Oc7qrTLk5ziOPb6nyY-mDNesiVj6na9mEsF331LaYfvo-3z9CBN312z_f7Efr6_uzL9mN9cfnhfHt6UdvibK5b7CRXUhImnHeG084XYwyM59B4zy23tHOt6hSDlhEjrDTWKmcZbzsmMD1C73a609IOrrOuODW9nlIYTLrT0QT9d2UM3_VVvNGEg2BYFYHXe4EUfy4uz3oI2bq-N6OLS9aci0YqAQV89Q94HZc0luG0IpTKRjJSILyDbIo5J-fvnWDQa1R6F5UuUek1Kr06ePnnCA8v9tkU4HgPmFz-2Ccz2pDvOYJlQ4GKwpEdl0tpvHLpweH_u_8GWlutdQ</recordid><startdate>20090101</startdate><enddate>20090101</enddate><creator>Campbell, Emily M.</creator><creator>Guappone, Kenneth P.</creator><creator>Sittig, Dean F.</creator><creator>Dykstra, Richard H.</creator><creator>Ash, Joan S.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20090101</creationdate><title>Computerized Provider Order Entry Adoption: Implications for Clinical Workflow</title><author>Campbell, Emily M. ; Guappone, Kenneth P. ; Sittig, Dean F. ; Dykstra, Richard H. ; Ash, Joan S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c497t-b1e86988257efea63df22850af604ff6c6c3deb9d950b52a7c8acc9ec56bd5713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Attitude of Health Personnel</topic><topic>Attitude to Computers</topic><topic>Biological and medical sciences</topic><topic>Computerized physician order entry</topic><topic>Delivery of Health Care - statistics & numerical data</topic><topic>Delivery of Health Care - trends</topic><topic>General aspects</topic><topic>Health participants</topic><topic>Hospitals</topic><topic>Hospitals - statistics & numerical data</topic><topic>Hospitals - trends</topic><topic>Humans</topic><topic>Information systems</topic><topic>Internal Medicine</topic><topic>Medical Order Entry Systems - statistics & numerical data</topic><topic>Medical Order Entry Systems - trends</topic><topic>Medical Records Systems, Computerized - statistics & numerical data</topic><topic>Medical Records Systems, Computerized - trends</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Miscellaneous</topic><topic>Original</topic><topic>Original Article</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Technology adoption</topic><topic>User interface</topic><topic>Workload</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Campbell, Emily M.</creatorcontrib><creatorcontrib>Guappone, Kenneth P.</creatorcontrib><creatorcontrib>Sittig, Dean F.</creatorcontrib><creatorcontrib>Dykstra, Richard H.</creatorcontrib><creatorcontrib>Ash, Joan S.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of general internal medicine : JGIM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Campbell, Emily M.</au><au>Guappone, Kenneth P.</au><au>Sittig, Dean F.</au><au>Dykstra, Richard H.</au><au>Ash, Joan S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Computerized Provider Order Entry Adoption: Implications for Clinical Workflow</atitle><jtitle>Journal of general internal medicine : JGIM</jtitle><stitle>J GEN INTERN MED</stitle><addtitle>J Gen Intern Med</addtitle><date>2009-01-01</date><risdate>2009</risdate><volume>24</volume><issue>1</issue><spage>21</spage><epage>26</epage><pages>21-26</pages><issn>0884-8734</issn><eissn>1525-1497</eissn><abstract>ABSTRACT
OBJECTIVE
To identify and describe unintended adverse consequences related to clinical workflow when implementing or using computerized provider order entry (CPOE) systems.
METHODS
We analyzed qualitative data from field observations and formal interviews gathered over a three-year period at five hospitals in three organizations. Five multidisciplinary researchers worked together to identify themes related to the impacts of CPOE systems on clinical workflow.
RESULTS
CPOE systems can affect clinical work by 1) introducing or exposing human/computer interaction problems, 2) altering the pace, sequencing, and dynamics of clinical activities, 3) providing only partial support for the work activities of all types of clinical personnel, 4) reducing clinical situation awareness, and 5) poorly reflecting organizational policy and procedure.
CONCLUSIONS
As CPOE systems evolve, those involved must take care to mitigate the many unintended adverse effects these systems have on clinical workflow. Workflow issues resulting from CPOE can be mitigated by iteratively altering both clinical workflow and the CPOE system until a satisfactory fit is achieved.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>19020942</pmid><doi>10.1007/s11606-008-0857-9</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of general internal medicine : JGIM, 2009-01, Vol.24 (1), p.21-26 |
| issn | 0884-8734 1525-1497 |
| language | eng |
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| source | Springer Nature; PubMed Central |
| subjects | Attitude of Health Personnel Attitude to Computers Biological and medical sciences Computerized physician order entry Delivery of Health Care - statistics & numerical data Delivery of Health Care - trends General aspects Health participants Hospitals Hospitals - statistics & numerical data Hospitals - trends Humans Information systems Internal Medicine Medical Order Entry Systems - statistics & numerical data Medical Order Entry Systems - trends Medical Records Systems, Computerized - statistics & numerical data Medical Records Systems, Computerized - trends Medical sciences Medicine Medicine & Public Health Miscellaneous Original Original Article Public health. Hygiene Public health. Hygiene-occupational medicine Technology adoption User interface Workload |
| title | Computerized Provider Order Entry Adoption: Implications for Clinical Workflow |
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