Orderset Strategy for Meaningful Use – Preparing for CPOE

Anyone who tells you that implementing CPOE is a walk in the park, doesn’t get out much.  In fact, implementing CPOE is one of the most challenging components of a hospital information system.  We have helped many hospitals implement CPOE and here are the challenges we’ve seen repeatedly:

• Physicians find it easier to write or verbalize orders – reluctant to enter themselves
• Pharmacists and Clinicians use different names for the same medication
• Lack of a unified body to oversee the creation and management of Ordersets
• Electronic Signatures can be technically challenging
• Not enough equipment and/or equipment not in the correct locations
• Everyone wants their own Ordersets, and the numbers have become unmanageable

Meaningful Use is going to dictate that every hospital adopts CPOE.  It’s not a secret - we all know it is coming – in fact, the latest inpatient requirement for 2011 is that 10% of all orders directly entered by an authorizing provider, must be through CPOE (and ED orders most likely won’t count.)  So if you don’t have CPOE plans in the works, you’d better get moving.

Question: What is CPOE without Ordersets?

Answer: Unsuccessful.

You remember the old saying that you should have a good manual process before you automate it?  While that doesn’t always apply, it certainly does apply to Orderset development.  Poor leadership in this area will cause your project to take an excessively long time to complete.  You must be able to quickly gather the Ordersets that will make up your organization’s CPOE backbone.  There are a number of steps to accomplish this:

1. Build a multi-disciplinary team structure for rapid review and approval
2. Collect and categorize all current Ordersets, paper or electronic
3. Identify commonalities
4. Develop a template that is categorized by discipline, Rad, Meds, Labs, etc.
5. Draft guidelines for what the organization will allow, such as should each physician be allowed his or her own set of admission orders or should a more universal one be built
6. Draft the list of Ordersets to be developed
7. Begin the efforts

 All these steps can be going on outside of the IT arena.  In other words, let the IT department work on the technical details of software, screen build, table structure, electronic signing, security, etc., while another group tackles the compilation of Ordersets.

While I oversimplified steps 1-7, my intention is to let you know that there is a process and approach that can be applied to get this done as painlessly as possible.

Atlanticon has experts that provide great guidance and leadership in helping lead your Orderset development.  You don’t want this step to be the one that hinders the completion of a good CPOE project.  If you would like to discuss this or enlist our help, please don’t hesitate to contact us.