Effect of computerized prescriber order entry on pharmacy: Experience of one health system [Practice Reports]

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Effect of computerized prescriber order entry on pharmacy: Experience of one health system Carmit K. McMullen?, Tara A. Macey, Jill Pope, Brian Gugerty, Marti Slot, Peter Lundeen, Joan Ash and Neil Carlson

Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids. Address correspondence to Dr. McMullen (carmit.mcmullen{at}kpchr.org). Abstract Purpose Pharmacists’ satisfaction with a computerized prescriber order-entry (CPOE) system and the impact of CPOE on pharmacy workflows and order verification were investigated.

Summary A mixed-method study was conducted to evaluate the implementation of a CPOE system in three hospitals of a large Michigan-based health system and early user experience with the system. Surveys of pharmacists before (n = 54) and after (n = 42) CPOE implementation indicated that they held generally positive expectations about CPOE prior to and during system implementation and continued to hold positive views about CPOE after several months of system use. In interviews and focus group discussions, pharmacists reported a number of important CPOE benefits, but they also cited challenges related to CPOE provider alerts, uncertainty about medication timing, and the need to support providers by serving as informal CPOE system trainers. Direct observation of pharmacists before and after CPOE implementation indicated decreases in both the rate of order clarification events (from 0.89 to 0.35 per hour, p < 0.001) and the average time spent per hour clarifying orders (from 4.75 to 2.11 minutes, p = 0.008).

Conclusion Several months after CPOE implementation, pharmacists indicated that several aspects of their workload had improved, including the process of medication order clarification, their ability to prioritize work, and their ability to move around within the hospital to respond to demand. However, pharmacists also noted that order ambiguity still existed and that the system needed to be optimized to gain efficiencies and increase clarity.

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? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp140106 American Journal of Health-System Pharmacy January 15, 2015 vol. 72 no. 2 133-142 ? Abstract Full Text Full Text (PDF) Classifications Print Content Practice Reports Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by McMullen, C. K. Articles by Carlson, N. PubMed PubMed citation Articles by McMullen, C. K. Articles by Carlson, N. Related Content Load related web page information Social Bookmarking CiteULike Delicious Digg Facebook Google+ Reddit Twitter What's this?

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