Physician satisfaction with transition from CPOE to paper-based prescription. (July 2017)

• Record Type: Journal Article
• Authors: Griffon, N.; Schuers, M.; Joulakian, M.; Bubenheim, M.; Leroy, J.-P.; Darmoni, S.J.
• Is Part Of: International journal of medical informatics. Volume 103(2017)
• Page Start: 42
• Page End: 48
• Publication Date: 2017-07
• Subjects: Medical order entry systems -- Cross-sectional studies -- Qualitative research; Medical informatics -- Periodicals; Information science -- Periodicals; Computers -- Periodicals; Medical technology -- Periodicals; Medical Informatics -- Periodicals; Technology, Medical -- Periodicals; Computers; Information science; Medical informatics; Medical technology; Electronic journals; Periodicals; Electronic journals; 610.285
• DOI: 10.1016/j.ijmedinf.2017.04.007
• Languages: English
• ISSNs: 1386-5056

Abstract

Highlights: Users reported poor satisfaction with the computerized provider order entry system. Reliability and user interface design are highly important in health information technology. The switch from computerized provider order entry towards paper based order entry was well accepted. Even in an emergency setting, the switch is possible with no perceptible impact on patient safety. Issues identified by a satisfaction survey eased the redeployment of computerized provider order entry. Abstract: Introduction: In January 2015, Rouen University Hospital's information system experienced serious issues. It was necessary to rapidly switch from the computerized provider order entry (CPOE) system towards a paper-based order entry (PBOE) system. This was an opportunity to evaluate prescriber opinion on the two provider order entry (POE) systems. Methods: All residents were asked to fill an augmented version of the POE satisfaction and usage survey for both POE systems. The results were compared to identify the strengths and weaknesses of each system. Results: Fifty-one respondents had used the CPOE system and the PBOE system. Overall, satisfaction was higher with PBOE than CPOE (odds ratio (OR) = 3.74; p < 0.001). Usability (OR = 4.00; p < 0.001), reliability (OR = 8.54; p < 0.001), time consumption (OR = 0.50; p < 0.05 – survey statement was formulated negatively), and communication with nurses (OR = 14.27; p < 0.0001) reached statistically better agreement. The more experience with CPOE the more residents were disillusioned with the reliability (OR = 6.55; p < 0.01), the usability (OR = 5.68; p < 0.01) and the patient safety (OR = 0.27; p < 0.05 – survey statement was formulated negatively) of CPOE. Although safety issues were reported for both systems, the causes were different; PBOE imposed frequent rewriting of the order while CPOE lack of usability might be unsafe. Another important issue with both POE systems was time consumption. Conclusion: Residents did not report any increase in safety issues with the rapid switch from CPOE to PBOE. They even seemed more satisfied with the rollback to paper, which remains a possible degraded mode in case of health information technology collapse.