OpenVista Computerized Provider Order Entry (CPOE)
National healthcare quality and safety experts agree that computerized provider order entry systems offer significant benefits, leading The Leapfrog Group and others to recommend CPOE as a key safety practice. Research shows that CPOE could help prevent up to three million serious medication errors each year if implemented in urban hospitals nationwide. Studies also show CPOE reduces length of stay, repeat tests, and turnaround times for laboratory, pharmacy and radiology requests.
CPOE Key to Meaningful Use
Key to achieving "meaningful use" of health IT, CPOE is a requirement for any provider serious about leveraging American Recovery and Reinvestment Act federal funding. Under ARRA, more than 30 percent of patients with at least one medication in their record must have at least one of those entered using CPOE. The proposed rules also call for healthcare providers to use electronic health records to check for potential drug interactions.
Proven over decades of use at the VA (in its VistA incarnation), OpenVista CPOE enables clinicians to create orders from within the same area of the clinical record that provides relevant patient data, and offers such time-saving functions as quick orders, clinical decision support, disease-specific evidence-based order sets and time-delay orders.
"More than half of U.S. practicing physicians have received training in VA hospitals," say VistA experts Douglas Goldstein and Peter J. Groen in their 2007 treatise on VistA entitled Medical Informatics 20/20: Quality and Electronic Health Records through Collaboration, Open Solutions, and Innovation (co-authored with Suniti Ponkshe and Marc Wine). Some say the figure is even higher since many medical schools purposefully situate themselves close to a Veterans Health Administration hospital. As Goldstein and Groen point out, "VA medical centers are affiliated with more than 152 medical and dental schools, training more than 80,000 health-related students and residents each year."
How does this translate into ease of adoption of OpenVistA CPOE? As many physicians have told us, the VA doesn't have the time or the need to train medical students and residents on VistA. They just start using it; it's that intuitive. OpenVista CPOE, which was based directly on VistA CPOE, is similarly intuitive and has the added benefit of looking surprisingly similar to the CPOE system many clinicians used during medical training. No wonder OpenVista CPOE enjoys virtually universal adoption at Medsphere's customer sites.
CPOE Field Notes
OpenVista CPOE Helps Midland Reach HIMSS Analytics Stage 6
After implementing OpenVista back in 2007—including CPOE—Midland Memorial Hospital now enjoys more than 50 percent overall CPOE compliance and 100 percent physician CPOE utilization. Click here for more on this Texas hospital, here for an independent case study.
Psychiatrists Like OpenVista CPOE, Too
“Physicians are famous for their handwriting, so electronic order entry, which eliminates handwritten prescriptions and other orders, is intrinsic to any patient safety initiative,” says Silver Hill Hospital President Sigurd Ackerman, MD. “Many of our physicians know VistA from their VA training rotations, making OpenVista, essentially a derivative of the VA system, pretty popular. All they wanted to know was ‘how soon can we make this happen?’”
OpenVista now gives Silver Hill clinicians access to a host of proven applications, including three that operate in tandem to prevent medication errors—computerized physician order entry (CPOE), medication order management (pharmacy) and a bar code medication administration (BCMA) application.
“Since humans will always make mistakes,” notes Ackerman, “we implemented a triple-check safety process to eliminate the potential for a medication error.”
Fig. 1. The OpenVista Orders tab with a cardiology orders template and Order Checks window.
Fig. 2. OpenVista CPOE facilitates quick, efficient ordering; decision support features guide clinicians in use of best-practice, evidence-based protocols.
OpenVista CPOE Benefits
- Increased Efficiency. Personalized order menus, tailored to provider and/or specialty, allow for timely and efficient delivery of care and standardized order sets, facilitating regulatory compliance.
- Improved Patient Safety. Multiple clinical alerts assist in the prevention of adverse events, while clinical decision support capabilities provide a safety net and ensure best practices are followed.
- Enhanced Communications. Electronic information exchange allows real-time communication of orders and results.
- Reduced Costs. CPOE reduces medical errors and eliminates duplicate procedures, decreasing length of stay and lowering provider liability.
OpenVista CPOE Features
- Offers time-saving functions such as quick orders and real-time clinical decision support to assist with better decision-making at the point of care
- Permits the configuration of disease-specific order sets, which can be personalized for individual providers or specialties
- Allows for preadmission, discharge, or transfer orders to occur at a future time
- Allows for efficient electronic signature for simultaneous multiple orders and verbal orders
- Improves patient safety through an efficient ordering process that incorporates informative clinical alerts:
- Out-of-range lab values
- Duplicate orders
- Maximum order frequency
- Potential negative drug interactions
- Other potential conflicts
- Provides notification of expiring orders and easy viewing of order status and nursing verification
- Gives providers the ability to identify signature surrogates and provide administrative authentication
- Provides the ability for users to customize views of patient information and set user-specific preferences
- Provides role-based security by requiring login and password information specific to the clinical privileges of the user