Emerging Health Care Technology: CPOE
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Emerging Health Care Technology: CPOE
- 1. Emerging Health Care Technology Presentation: CPOE
- 2. Introduction Federal government mandate Necessity with national and global technological advances Concurrent usability Minimizes delay in treatment Decrease in health care costs due to treatment duplication
- 3. Perceived Benefits of CPOE Red. Overutilization Faster Order Proc. Evid.Based Med. Improved Med. Safety 58 0 20 40 60 80HIMSS VANTAGE Point, 2009
- 4. Sample CPOE Screen Wager et al., 2009. Source: Partners Health Care (n.d.)
- 5. CPOE Security 1. 2. 3. 4. 5. Security Rule alignment Nine standards P & P to prevent, detect, contain, and correct violations EMR security officer Workforce security User authorization and modification Workforce training 6. Security breach reports 7. Contingency plan 8. Periodic evaluations 9. Formal agreements with associates. Physical Safeguards: Workstations Hardware Audits Authentication Encryption
- 6. Privacy Rule Applicable to CPOE Records must be accessible to appropriate staff Hardware and software safeguards Continual vigilance and maintenance of system Content controls may not be necessary Security analysis Vendor selection to include HIPAA Security Rule analysis
- 7. Conclusion Maximize health care quality Minimize health care costs Many types of software Applications adjustable to organization needs Security Rule as framework for system security
- 8. References Computerized provider order entry. (2009, October). HIMSS VANTAGE Point. Retrieved from http://www.himss.org/content/files/vantagepoint/pdf/VantagePoint_910.pdf Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health care information systems: A practical approach for health care management (2 ed.). Retrieved from https://ecampus.phoenix.edu/content/eBookLibrary2/content/TOC.asp x? assetdataid=478cdba4-ee6f-438c-885ffa59620ac43c&assetmetaid=7146cef6-85da-43fe-b9b3-7a3439c416a7 Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health care information systems: A practical approach for health care management (2 ed.). Sample CPOE screen [sample screen]. Source: Partners Health Care (n.d.). Retrieved from https://ecampus.phoenix.edu/content/eBookLibrary2/content/TOC.asp x? assetdataid=478cdba4-ee6f-438c-885ffa59620ac43c&assetmetaid=7146cef6-85da-43fe-b9b37a3439c416a7
Hinweis der Redaktion
- This presentation is by Lorraine Kelley, University of Phoenix student, for HCS/438. The facilitator is Mr. George DeRosa, MA.
- The adoption of electronic records is both a mandate of the federal government, and a necessity as the national and global technology arena advances. The electronic health record replaces the conventional paper chart. In doing so, the computerized record becomes concurrently usable to multiple care providers and clinicians. The accessibility of the electronic record minimizes delays in treatment. In addition, health care costs diminish because of the decrease in treatment duplication.
- Computerized order entry, or CPOE, is a technological emerging trend that has been identified as one aspect of meaningful use under the HITECH act. CPOE with clinical decision support is a major component of an electronic health record system ("Computerized provider order entry," 2009). With CPOE, physicians and other health care providers can electronically input patient orders for treatment. This includes laboratory and diagnostic test requisitions, medication orders and prescriptions, and therapies such as physical therapy or occupational therapy. Once the order is complete, the clinician who is responsible for carrying out that order can do so without delay. Both the in-patient and out-patient settings are equally suitable for CPOE. In a survey of physicians conducted by Healthcare Information and Management Systems, physicians perceived many benefits to the computerized provider order entry system, or CPOE. Improved medication safety, increased utilization of evidence-based medicine, faster order processing, and over-utilization of services reduction were important benefits of the CPOE (HIMSS VANTAGE Point, 2009). Another advantage to CPOE is the reduction is medical errors. Care providers can build into the system standard order sets that are adjustable to suit the individual needs of a patient. Decision support guidelines that are important for Joint Commission core measures and standards are retrievable. Programmers can also build alerts into the system for allergies or medication contraindications. Reminders also improve quality of care by informing care providers when follow-up visits or treatments are due. Automated order entry and provider input are the two distinct CPOE capabilities. According to Wager, Lee, & Glaser (2009), CPOE systems vary immensely. Some systems have vast decision support tools that include evidence-based practice guidelines. Some systems can also encourage the use of lower cost medications by alerting the care provider when an alternative is available.
- The slide is a sample screen from one CPOE vendor. Notice the patients identifiable information and insurance information is present on the home screen. In addition, allergy information, history, a notes page, flow sheets, and test results are easily retrievable. A safety and cost feature is that during a medication order, this application provides alternative recommendations.
- The CPOE system, as does the larger EMR system it comprises must be secure and align with the Health Insurance Portability and Accountability Act, or HIPPA. The Security Rule is the mandate for electronic health records, just as the Privacy Rule is the mandate for paper health records. The Security Rule has nine standards. The first standard is the security management function standard. This standard mandates that an organization has policies and procedures in place to prevent, detect, contain, and correct violations (Wager et al., 2009) The second mandate is the need for a unique person who has responsibility for EMR security. The third rule addresses workforce security. Processes must be in place to ensure employees with the proper authority have access to the EMR, a workforce clearance strategy, and a staff termination policy. User authorization and modification is the focus for the fourth rule. The fifth rule mandates the availability of workforce training regarding security. The sixth rule establishes that there is a security breach reporting system. The seventh rule concerns a contingency plan in case of system or power failure. The plan must include strategies to backup and recover data and include an emergency mode. The eighth standard requires periodic evaluations of the system. The last standard consists of a mandate that the entity’s business associates have a formal agreement concerning PHI exchange In addition, physical safeguards require the security of workstations, control of hardware, movement of hardware within and out of the facility, audit procedures, and user authentication. Personal health data must also be encrypted to remain secure when necessary (Wager et al., 2009).
- The mandates under the Privacy Rule are applicable to the implementation and maintenance of the CPOE. The CPOE must only be usable to appropriate staff. Safeguards for both the software and hardware must be put in place. In addition, continual vigilance and maintenance of the system is mandatory to protect PHI (Wager et al., 2009). As a part of the larger EMR, the CPOE will have these requirements built in. Some components, like content controls may not be appropriate in every department. The organization must complete an individual security analysis. The vendor selection must contain an in-depth analysis of HIPAA Security Rule provisions. Only those vendors who are in alignment with all standards will deem consideration for implementation.
- As a component of the electronic record, CPOE will maximize health care quality and minimize health care costs. Many types of software are available and are adjustable to the needs of the health care organization. A challenge regarding the implementation of the EMR is the provision of patient information security. HIPAA, through the Security Rule, has given guidelines to health care entities. These guidelines can be the framework by which patient records remain secure. Through the use of CPOE and the applicable security mandates, patients will receive efficient and safe health care.