Assessing the anticipated consequences of Computer-based Provider Order Entry at three community hospitals using an open-ended, semi-structured survey instrument
Abstract Objective To determine what “average” clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals. Methods We created an open-ended, semi-structur...
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Published in: | International journal of medical informatics (Shannon, Ireland) Vol. 77; no. 7; pp. 440 - 447 |
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Abstract | Abstract Objective To determine what “average” clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals. Methods We created an open-ended, semi-structured, interview survey template that we customized for each organization. This interview-based survey was designed to be administered orally to clinicians and take approximately 5 min to complete, although clinicians were allowed to discuss as many advantages or disadvantages of the impending system roll-out as they wanted to. Results Our survey findings did not reveal any overly negative, critical, problematic, or striking sets of concerns. However, from the standpoint of unintended consequences, we found that clinicians were anticipating only a few of the events, emotions, and process changes that are likely to result from CPOE. Conclusions The results of such an open-ended survey may prove useful in helping CPOE leaders to understand user perceptions and predictions about CPOE, because it can expose issues about which more communication, or discussion, is needed. Using the survey, implementation strategies and management techniques outlined in this paper, any chief information officer (CIO) or chief medical information officer (CMIO) should be able to adequately assess their organization's CPOE readiness, make the necessary mid-course corrections, and be prepared to deal with the currently identified unintended consequences of CPOE should they occur. |
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AbstractList | Objective - To determine what "average" clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals. Methods - We created an open-ended, semi- structured, interview survey template that we customized for each organization. This interview-based survey was designed to be administered orally to clinicians and take approximately 5 min to complete, although clinicians were allowed to discuss as many advantages or disadvantages of the impending system roll-out as they wanted to. Results - Our survey findings did not reveal any overly negative, critical, problematic, or striking sets of concerns. However, from the standpoint of unintended consequences, we found that clinicians were anticipating only a few of the events, emotions, and process changes that are likely to result from CPOE. Conclusions - The results of such an open-ended survey may prove useful in helping CPOE leaders to understand user perceptions and predictions about CPOE, because it can expose issues about which more communication, or discussion, is needed. Using the survey, implementation strategies and management techniques outlined in this paper, any chief information officer (CIO) or chief medical information officer (CMIO) should be able to adequately assess their organization's CPOE readiness, make the necessary mid-course corrections, and be prepared to deal with the currently identified unintended consequences of CPOE should they occur. OBJECTIVETo determine what "average" clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals. METHODSWe created an open-ended, semi-structured, interview survey template that we customized for each organization. This interview-based survey was designed to be administered orally to clinicians and take approximately 5 min to complete, although clinicians were allowed to discuss as many advantages or disadvantages of the impending system roll-out as they wanted to. RESULTSOur survey findings did not reveal any overly negative, critical, problematic, or striking sets of concerns. However, from the standpoint of unintended consequences, we found that clinicians were anticipating only a few of the events, emotions, and process changes that are likely to result from CPOE. CONCLUSIONSThe results of such an open-ended survey may prove useful in helping CPOE leaders to understand user perceptions and predictions about CPOE, because it can expose issues about which more communication, or discussion, is needed. Using the survey, implementation strategies and management techniques outlined in this paper, any chief information officer (CIO) or chief medical information officer (CMIO) should be able to adequately assess their organization's CPOE readiness, make the necessary mid-course corrections, and be prepared to deal with the currently identified unintended consequences of CPOE should they occur. Abstract Objective To determine what “average” clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals. Methods We created an open-ended, semi-structured, interview survey template that we customized for each organization. This interview-based survey was designed to be administered orally to clinicians and take approximately 5 min to complete, although clinicians were allowed to discuss as many advantages or disadvantages of the impending system roll-out as they wanted to. Results Our survey findings did not reveal any overly negative, critical, problematic, or striking sets of concerns. However, from the standpoint of unintended consequences, we found that clinicians were anticipating only a few of the events, emotions, and process changes that are likely to result from CPOE. Conclusions The results of such an open-ended survey may prove useful in helping CPOE leaders to understand user perceptions and predictions about CPOE, because it can expose issues about which more communication, or discussion, is needed. Using the survey, implementation strategies and management techniques outlined in this paper, any chief information officer (CIO) or chief medical information officer (CMIO) should be able to adequately assess their organization's CPOE readiness, make the necessary mid-course corrections, and be prepared to deal with the currently identified unintended consequences of CPOE should they occur. To determine what “average” clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals. We created an open-ended, semi-structured, interview survey template that we customized for each organization. This interview-based survey was designed to be administered orally to clinicians and take approximately 5 min to complete, although clinicians were allowed to discuss as many advantages or disadvantages of the impending system roll-out as they wanted to. Our survey findings did not reveal any overly negative, critical, problematic, or striking sets of concerns. However, from the standpoint of unintended consequences, we found that clinicians were anticipating only a few of the events, emotions, and process changes that are likely to result from CPOE. The results of such an open-ended survey may prove useful in helping CPOE leaders to understand user perceptions and predictions about CPOE, because it can expose issues about which more communication, or discussion, is needed. Using the survey, implementation strategies and management techniques outlined in this paper, any chief information officer (CIO) or chief medical information officer (CMIO) should be able to adequately assess their organization's CPOE readiness, make the necessary mid-course corrections, and be prepared to deal with the currently identified unintended consequences of CPOE should they occur. To determine what "average" clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals. We created an open-ended, semi-structured, interview survey template that we customized for each organization. This interview-based survey was designed to be administered orally to clinicians and take approximately 5 min to complete, although clinicians were allowed to discuss as many advantages or disadvantages of the impending system roll-out as they wanted to. Our survey findings did not reveal any overly negative, critical, problematic, or striking sets of concerns. However, from the standpoint of unintended consequences, we found that clinicians were anticipating only a few of the events, emotions, and process changes that are likely to result from CPOE. The results of such an open-ended survey may prove useful in helping CPOE leaders to understand user perceptions and predictions about CPOE, because it can expose issues about which more communication, or discussion, is needed. Using the survey, implementation strategies and management techniques outlined in this paper, any chief information officer (CIO) or chief medical information officer (CMIO) should be able to adequately assess their organization's CPOE readiness, make the necessary mid-course corrections, and be prepared to deal with the currently identified unintended consequences of CPOE should they occur. |
Author | Ash, Joan S Guappone, Ken P Sittig, Dean F Campbell, Emily M Dykstra, Richard H |
AuthorAffiliation | 2 Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 1 Medical Informatics Department, Northwest Permanente, P.C., Portland, OR |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/17931963$$D View this record in MEDLINE/PubMed |
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References | Tenner (bib21) 1996 Morrissey (bib23) 2004 Childs (bib14) 2006 Ash, Sittig, Seshadri, Dykstra, Carpenter, Stavri (bib26) 2005; 74 Patton (bib18) 2002 Koppel, Metlay, Cohen, Abaluck, Localio, Kimmel, Strom (bib3) 2005; 293 Chin (bib15) 1998 Massaro (bib22) 1993; 68 (bib1) 2006 Campbell, Sittig, Ash, Guappone, Dykstra (bib8) 2006; 13 Stablein, Welebob, Johnson, Metzger, Burgess, Classen (bib31) 2003; 29 E.M. Campbell, D.F. Sittig, K.P. Guappone, R.H. Dykstra, J.S. Ash, Overdependence on Technology: An unintended adverse consequence of computerized provider order entry. AMIA Annu. Symp. Proc. 2007. (under review). Han, Carcillo, Venkataraman (bib5) 2005; 116 KLAS CPOE Digest 2007 Release Date 2/23/2007. Trotter, Needle, Goosby (bib10) 2001; 13 M.Tanenbaum, Hospital vexed by new computer system. Mountain View Voice, July 14, 2006. Available at Scrimshaw, Hurtado (bib9) 1987 Kuperman, Gibson (bib2) 2003; 139 Sittig, Guappone, Campbell, Dykstra, Ash (bib7) 2007 Anderson, Ramanujam, Hensel, Anderson, Sirio (bib27) 2006; 75 Ash, Stavri, Dykstra, Fournier (bib32) 2003; 69 Nebeker, Hoffman, Weir (bib4) 2005; 165 Gliner, Morgan (bib17) 2000 J.S. Ash, D.F. Sittig, E.M. Campbell, et al. An unintended consequence of cpoe implementation: shifts in power, control, and autonomy. Proc. Am. Med. Inform. Assoc. Fall Symp., in press. . Ash, Sittig, Dykstra, Guappone, Carpenter, Seshadri (bib6) 2006 Stavri, Ash (bib28) 2003; 72 Poissant, Pereira, Tamblyn, Kawasumi (bib19) 2005; 12 J.P. Barrett, R.A. Barnum, B.B. Gordon, et al. Final report on evaluation of the implementation of a medical information system in a general community hospital. Battelle Laboratories (NTIS PB 248 340), December 19, 1975. Kilbridge (bib33) 2003; 348 Handwerker (bib11) 2001 Ash, Stavri, Kuperman (bib25) 2003; 10 For a list of CPOE-related articles see the Bibliography section on Sittig, Ash, Zhang, Osheroff, Shabot (bib30) 2006; 118 Miller, Waitman, Chen (bib16) 2005; 38 Ash, Sittig, Poon, Guappone, Campbell, Dykstra (bib24) 2007; 14 16799128 - J Am Med Inform Assoc. 2006 Sep-Oct;13(5):547-56 17460127 - J Am Med Inform Assoc. 2007 Jul-Aug;14(4):415-23 16948338 - Healthc Inform. 2006 Aug;23(8):56-7 15755942 - JAMA. 2005 Mar 9;293(10):1197-203 16882838 - Pediatrics. 2006 Aug;118(2):797-801 14644302 - Int J Med Inform. 2003 Dec;72(1-3):9-15 12856555 - Jt Comm J Qual Saf. 2003 Jul;29(7):336-44 16322178 - Pediatrics. 2005 Dec;116(6):1506-12 15905487 - J Am Med Inform Assoc. 2005 Sep-Oct;12(5):505-16 18693805 - AMIA Annu Symp Proc. 2007;:94-8 15015393 - Mod Healthc. 2004 Feb 23;34(8):16 16870501 - Int J Med Inform. 2006 Dec;75(12):809-17 15964780 - Int J Med Inform. 2005 Aug;74(7-8):623-8 16793330 - Int J Med Inform. 2007 Jun;76 Suppl 1:S21-7 15911723 - Arch Intern Med. 2005 May 23;165(10):1111-6 12834316 - Ann Intern Med. 2003 Jul 1;139(1):31-9 12621131 - N Engl J Med. 2003 Mar 6;348(10):881-2 8447887 - Acad Med. 1993 Jan;68(1):20-5 16290243 - J Biomed Inform. 2005 Dec;38(6):469-85 17911717 - Stud Health Technol Inform. 2007;129(Pt 1):252-6 12626376 - J Am Med Inform Assoc. 2003 May-Jun;10(3):229-34 17238293 - AMIA Annu Symp Proc. 2006;:11-5 12810127 - Int J Med Inform. 2003 Mar;69(2-3):235-50 Stablein (10.1016/j.ijmedinf.2007.08.005_bib31) 2003; 29 Sittig (10.1016/j.ijmedinf.2007.08.005_bib30) 2006; 118 Chin (10.1016/j.ijmedinf.2007.08.005_bib15) 1998 10.1016/j.ijmedinf.2007.08.005_bib13 10.1016/j.ijmedinf.2007.08.005_bib35 Ash (10.1016/j.ijmedinf.2007.08.005_bib6) 2006 10.1016/j.ijmedinf.2007.08.005_bib12 10.1016/j.ijmedinf.2007.08.005_bib34 Anderson (10.1016/j.ijmedinf.2007.08.005_bib27) 2006; 75 Morrissey (10.1016/j.ijmedinf.2007.08.005_bib23) 2004 Childs (10.1016/j.ijmedinf.2007.08.005_bib14) 2006 Patton (10.1016/j.ijmedinf.2007.08.005_bib18) 2002 Handwerker (10.1016/j.ijmedinf.2007.08.005_bib11) 2001 Massaro (10.1016/j.ijmedinf.2007.08.005_bib22) 1993; 68 10.1016/j.ijmedinf.2007.08.005_bib29 Koppel (10.1016/j.ijmedinf.2007.08.005_bib3) 2005; 293 Ash (10.1016/j.ijmedinf.2007.08.005_bib24) 2007; 14 (10.1016/j.ijmedinf.2007.08.005_bib1) 2006 Kilbridge (10.1016/j.ijmedinf.2007.08.005_bib33) 2003; 348 Gliner (10.1016/j.ijmedinf.2007.08.005_bib17) 2000 Tenner (10.1016/j.ijmedinf.2007.08.005_bib21) 1996 Kuperman (10.1016/j.ijmedinf.2007.08.005_bib2) 2003; 139 Nebeker (10.1016/j.ijmedinf.2007.08.005_bib4) 2005; 165 Sittig (10.1016/j.ijmedinf.2007.08.005_bib7) 2007 Trotter (10.1016/j.ijmedinf.2007.08.005_bib10) 2001; 13 Poissant (10.1016/j.ijmedinf.2007.08.005_bib19) 2005; 12 10.1016/j.ijmedinf.2007.08.005_bib20 Campbell (10.1016/j.ijmedinf.2007.08.005_bib8) 2006; 13 Ash (10.1016/j.ijmedinf.2007.08.005_bib32) 2003; 69 Miller (10.1016/j.ijmedinf.2007.08.005_bib16) 2005; 38 Scrimshaw (10.1016/j.ijmedinf.2007.08.005_bib9) 1987 Han (10.1016/j.ijmedinf.2007.08.005_bib5) 2005; 116 Stavri (10.1016/j.ijmedinf.2007.08.005_bib28) 2003; 72 Ash (10.1016/j.ijmedinf.2007.08.005_bib25) 2003; 10 Ash (10.1016/j.ijmedinf.2007.08.005_bib26) 2005; 74 |
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Snippet | Abstract Objective To determine what “average” clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were... To determine what “average” clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we... To determine what "average" clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we... Objective - To determine what "average" clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to... OBJECTIVETo determine what "average" clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to... |
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SubjectTerms | Attitude of Health Personnel Community Data Collection Ethnology Hospitals Hospitals, Community - statistics & numerical data Internal Medicine Medical informatics Medical Order Entry Systems Medical Order Entry Systems - statistics & numerical data Oregon Other Practice Patterns, Physicians' - statistics & numerical data Program Evaluation - methods |
Title | Assessing the anticipated consequences of Computer-based Provider Order Entry at three community hospitals using an open-ended, semi-structured survey instrument |
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