Healthcare Policy Term Paper

Healthcare Policy Analysis

The objective of this study is to conduct a healthcare policy analysis and recommend changes.

Presently, there is not an across-the-board implementation of Computerized Physician Order Entry (CPOE) or prescriptions and this can be critical in reducing adverse drug events. This study argues that the use of the Computerized Physician Order Entry (CPOE) should be implemented and utilized across the entire health care system.

Review of Studies on the Use of CPOE

The work of Steele and DeBrow (nd) states that computerized provider order entry (CPOE) is an electronic process "that allows a health care provider to enter orders electronically and to manage the results of those orders. CPOE has received increased attention, based on the Institute of Medicine (IOM) reports, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, and the recommendation of the Leapfrog Group (a coalition of public and private organizations providing health care benefits) that hospitals introduce systems for prescribing and that they be rewarded for it." (p.1)

It is reported that the issues addressed in use of CPOE included:

(1) Reducing the potential for human error.

(2) Reducing time to care delivery.

(3) Improving order accuracy.

(4) Decreasing time for order confirmation and turnaround.

(5) Improving clinical decision support at the point of care.

(6) Making crucial information more readily available.

(7) Improving communication among physicians, nurses, pharmacists, other clinicians, and patients. (Steel and Debrow, nd, p. 2)

The team reports the primary focus of integration of the computerized ordering process into the workflow of the providers and ancillary staff." (Steele and Debrow, nd, p. 2) Findings of the study show that "turnaround times for orders place to all three ancillary departments decreased significantly when the pre- to post-CPOE time periods were compared. Absolute reductions in TAT occurred in all three departments, with decreases of 79 minutes for laboratory orders, 1,146 minutes (19.1 hours) for radiology, and 36.7 minutes for pharmacy. As shown in Table 1, TATs decreased by 55.6% (P <.0001) for laboratory, 61.6% (P <.0001) for radiology, and 83.4% (P <.0001) for pharmacy." (Steel and Debrow, nd, p. 4) Noted as the primary benefit of CPOE was the "reduction in medication errors." (Steel and Debrow, nd, p. 5) The work of Berger and Kichak (2004) also examined the use of CPOE and reports that "here are now numerous CPOE systems (both commercial and proprietary) available and, like all software, some could fit the needs of specific institutions better than others. CPOE is also just one part of overall software solutions designed to theoretically improve patient outcomes." (p. 1) The work of Walsh, et al. (2008) reports a study that examined the use of CPOE on preventing medication errors and reports that "the rate of nonintercepted serious medication errors in this pediatric population was reduced by 7% after the introduction of a commercial computerized physician order entry system." (p. 1) A study reported by Potts, et al. (2004) examined the use of CPOE and states conclusions that the implementation of CPOE "resulted in almost a complete elimination of MPEs and RVs and a significant but less dramatic effect on potential ADEs." (p. 1) The work of Kuperman and Gibson (2003) examines the use of Computer Physician Order Entry and states "Several analyses have detected substantial quality problems throughout the health care system. Information technology has consistently been identified as an important component of any approach for improvement. Computerized physician order entry (CPOE) is a promising technology that allows physicians to enter orders into.....