CPOE Implementation in ICUs. Inclusive Dates: 09/01/04 - 08/31/09.

摘要

The purpose of this project was to systematically assess CPOE/EHR in ICUs. The project focused on the implementation and use of CPOE/EHR in four ICUs of Geisinger Medical Center. Multiple data collection methods were used to examine the impact of CPOE/EHR on (1) medication safety and quality of care, (2) the job tasks and perceptions of ICU staff, and (3) financial value. We also studied the value of using human factors methods (i.e. usability training and proactive risk assessment) before technology implementation. This very large complex technology implementation had no overall negative effect. We observed some short-term negative effects, such as decreased perception of communication timeliness. These negative effects disappeared about one year post-implementation. We observed changes in job tasks done by nurses, physicians and PAs, such as increased time spent on documentation and review tasks. Our results actually show some benefit of CPOE/EHR on timeliness of IV medication delivery. The CPOE/EHR implementation was accompanied by major attention to organizational issues and change management by the organization. We demonstrated the feasibility and benefits of using human factors methods, such as usability and proactive risk assessment, before the technology is fully designed and implemented.