CPOE Revelations

So, what should hospital and health system CIOs think about all this? “I would say that, as the Health Affairs article discusses, because successful configuration of clinical decision support is not out of the box, it takes a new process, and groups of people working on this, and learning from other peer hospitals how to do this, and keeping at it,” in order to succeed,” says CSC's Metzger. “It's really that process of incorporating clinical knowledge, some logical knowledge, into the system. So the message to the CIO is, who's involved and what are they doing? Is the P and T Committee involved? Do we have a plan for constantly moving forward with decision support? And how often is an order changed as a result of this device? It's about actively working on those questions.”

What's more, Metzger says, “It's really about the nurses and physicians telling the techno-geeks how to embed technical knowledge so it helps the clinicians avert mistakes.” Among the challenges, she notes, is the mountainous one of providing sufficiently robust clinical decision support at the point of care that can actually help physicians avert a majority of potential avoidable errors, no mean feat in today's context of functionality The list of issues shown in figure 1 provides a very good start in terms of elements to look at, she notes.

In the end, Metzger says, it's clear there is no easy short-cut to achieving success in this critical area. At least, the guidelines for meaningful use under the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act will provide some clarity for clinician and IT leaders going forward.

Healthcare Informatics 2010 June;27(6):74-76