1. Provide a brief overview of the case (one paragraph or less). What is this case about?
-This case study talks about Emory Clinic implementing a computerized provider order entry system and describes the changes the clinic went through. The case study also talks about how the system affected the hospital and the healthcare works when implementing to system. It discusses people’s reaction to the system and the advantages and problems that arise when the system was being implemented.
2. What is the purpose of a CPOE system?
-The purpose of a CPOE system is it was designed to reduce, or, whatever possible, eliminate handwritten orders. Some of the advantages of the CPOE system over the handwritten process are that they are less likely subject to errors, free of handwriting identification problems, less subject to errors, and provide “real time” decision support.
3. How might a CPOE system change work flow in a medical setting? What type of business process reengineering (BPR) occurred at Emory as part of this project?
-The type of business process reengineering that occurred during the implementation of the CPOE system was the shift in the workload. According to the case study, the CPOE system was an overall positive in the workforce as it reduced errors in a medical setting. Instead of handing off orders to intermediaries, they can just directly enter an order to the system for others to see. There was a natural shift in workload from nurses, pharmacists, social workers, ward clerks, and other healthcare providers to physicians. Doctors were left with a higher workload due to the change of the process and the case study states that they hate it. The CPOE system created a new workplace dynamic in which the doctors responsibility for order entry was not always clearly defined. On the other hand, some other healthcare works got less of a workload. For example pharmacist Tony Ottaviano stated that his workload was reduced freeing up more time for him to actually doing what pharmacists are supposed to do instead of sitting and entering orders
4. At Emory, what were the goals of CPOE implementation? (Why was a decision made to do this?)
-The goals of implementing the CPOE system was to reduce human error. The advantages listed on page 14, listed all the reasons why it should be implemented. In the case study, they stated that there were more positives than negatives about the implementation. Overall the system made operations move at a quicker pace and helped most healthcare workers made less errors in a medical setting.
5. Access YouTube and view videos from at least three other healthcare organizations that have implemented CPOE systems. Identify the three organizations and summarize their implementation efforts.
– Adventist healthcare system http://www.youtube.com/watch?v=8tfLoWVAeHc Organizational change
Processing the system
Training their employees
– Crouse Hospital http://www.youtube.com/watch?v=OeziLJU_ZGw Talked about enhancements of the system such as safety
Mandatory rollout with more enhancements and improvements
Explain why it is an advantage and essential
Expanded to most units in hospital with enhancements and improvements -Floyd Medical Care http://www.youtube.com/watch?v=J9vPoQ65PiE Personal training
Explained why CPOE will make things easier
6. After reading the case and viewing the YouTube videos, identify who you think the stakeholders are in a CPOE implementation effort. Identify at least 10 different types of stakeholders.
1. IT department
4. CPOE creator
10. Socials workers
7. Next identify what you think critical steps are in a CPOE implementation effort. What do you see as being critical aspects of the project that can either lead to success or failure?
– In implementing the CPOE system, critical steps for implementing it successfully should be to think about each patient’s needs. The system is for the healthcare workers to use but depending on how this system is utilized could directly effect a patient’s medical procedures. I also think proper training is a critical step. This refers back to the patients being affected if not utilized correctly.
8. In hindsight, what changes can you recommend for the CPOE system implementation process at Emory that might have reduced issues? I expect you to draw on materials either from your real work experience or from information provided in the course so far. 5 points will be deducted from the score for students who answer “nothing” to this question. I expect more critical thinking than that.
-Some of the problems that existed at Emory were “post-op ordering process”, no gatekeeper, and an increase in lab orders. Some solutions I would recommend to solving some of the listed issues would be increasing the staff count. Having a low staff count with each individual having multiple duties can be tough. Having a higher staff count with a more segregation of duties would prevent a lot of issues from occurring (such as one person just verifying information). Also a big recommendation would be more training. Training can be very costly to an organization but it is better to have effective training than to endanger a patient’s life and having a law suit on their hands. In my real world experience, I currently work at sonic and there is no budget that goes into training. New employees are placed on the floor when they are hired and are told to just observe and other workers are to give advice and show them what to do. This is very inefficient because this makes each worker different as they may have their own way of doing an assigned task. Training should be implemented so that each worker does the same amount of work and work is fair.
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