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Large Hospital System Successfully Adopts CPOE for Radiology

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Broad adoption of a computerized physician order entry system with imaging decision support showed ability to improve health care delivery.

A computerized physician order entry (CPOE) system with imaging decision support was broadly accepted by clinicians at a large hospital system, with nearly all radiology studies being ordered through the system, according to a new study published in the February issue of the Journal of the American College of Radiology.

Researchers from the Brigham and Women’s Hospital in Boston assessed if CPOE would be used and accepted by clinicians throughout the hospital system, thereby improving delivery of health care by using image testing meaningfully rather than habitually. The study took place from January 2000 to June 2010 in outpatient, emergency department (ED), and in inpatient settings. A total of 4.1 million diagnostic studies were performed during that period.

Results showed that overall use of CPOE rose from 0.5 percent to 94.6 percent (2000 to 2010). Adoption varied across clinical settings, with an average of 89.8 percent use in the patient units and 99.2 percent in the ED. Areas slower to adopt the system were the surgical subspecialties and where physicians, such as obstetricians, spent the most time away from their computers.
Meaningful use (that is, fewer orders for low-yield tests) of electronically created orders rose from 0.4 percent to 61.9 percent (2000 to 2010) and electronically signed orders rose from 0.4 percent to 92.2 percent (2000 to 2010).

By adopting the CPOE decision support system, not only is the quality of care improved, but waste is reduced because of fewer inappropriate procedures, researchers said. “The meaningful use of health care IT can improve patient safety, efficiency, and the quality of care,” the authors wrote.

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