According to a recent report from the Orem, Utah-based KLAS Research, computerized physician order entry (CPOE) rates have grown almost 168 percent after the passage of the American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH). The report, "CPOE 2011: The ARRA Effect," states that the number of hospitals going live in 2010 has jumped to 233 per year since ARRA passed, from an average of 87.
Colin Buckley, strategic operations manager at KLAS, said the report’s findings were encouraging to those in the industry, however, healthcare organizations’ readiness for CPOE depends a lot on their vendor partners. “Most of the organizations doing CPOE are having a lot of success, and they’re going deeper, faster, so they shouldn’t have many problems with meaningful use stage goals,” Buckley says. “For folks that are not yet on their way with CPOE the biggest challenge is being able to get in line with their vendors and getting their internal resources and expectations in line to get everything done in the next few years.”
Buckley went further to say that the federal Stage 1 CPOE meaningful use requirement, which requires more than 30 percent of all patients with medication orders seen during the reporting period have at least one order placed using CPOE, was not that challenging for those organizations that had adopted CPOE already. He says that since the government has allowed organizations to include emergency room patients, Stage 1 is easier to satisfy because the ER has a high volume of medication orders. Also the government has since lowered the bar from CPOE being physician order entry, to provider order entry, meaning that any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines can be counted toward the Stage 1 threshold. (The KLAS report measures CPOE as physician order entry, so their numbers might not reflect all the CPOE going on out there.)
“Folks that are going live are generally not struggling to get past what would qualify for Stage 1,” Buckley says. “They’re going a lot deeper to 50, 60, 70, 80 percent of orders right away. There’s a lot more industry experience with CPOE; there’s a lot more resources out there for folks to rely on best practices from peers.”
The KLAS report also highlights CPOE leaders Cerner and Epic, and Buckley doesn’t find it surprising based on these vendors strong relationships and largely integrated systems and success in marketplace. This aligns with KLAS’ most recent EHR market share report (which profiled hospitals with more than 200 beds) that shows Cerner and Epic tied at around 275-300 hospitals each, behind market leader MEDITECH with 325-350 live installations. The CPOE report also calls out that fact that Allscripts is stumbling on CPOE after being an early leader. Buckley agreed with my hunch that it is likely due to the distraction of its merger with Eclipsys.