Survey: CPOE adoption on the rise, but full implementation is slow

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The adoption of computerized provider order entry (CPOE) appears to be more widespread than previously thought, although full use of the systems by clinicians may take longer than many expect, according to a survey of members of the College of Healthcare Information Management Executives (CHIME).

Respondents of the survey included 335 CHIME members, 199 of which reported their organizations currently have CPOE "at some level of adoption." When asked how long they believed it would take from implementation to achieve 100 percent adoption, 26.6 percent of respondents estimated it would take two years, 34.5 percent estimated it would take three years, 17.1 percent estimated it would take four years, and 13.3 percent predicted it would take five years. Only 8.5 percent of respondents said they believed it could be achieved in one year.

Other survey findings showed the use of CPOE by clinicians is relatively low, the college reported. Of systems with CPOE in place, 44.7 percent reported that physicians entered 20 percent or fewer orders on CPOE systems. Of 175 respondents with less than 100 percent adoption by physicians, 113 predict usage will increase by only 20 percentage points over the next year from the current level at their organization.

Though the results suggest that CPOE usage by clinicians will ramp up slowly, some respondents reported progress toward widespread use of the systems for reporting and communicating orders. Of the organizations with CPOE in place, 21.6 percent say they expect to achieve 90 percent order entry in the next 12 months.

CHIME said that the survey findings imply more healthcare organizations are beginning to implement CPOE systems than originally believed, but the rate at which clinicians are entering all orders on these systems is far slower than originally anticipated.

"Anticipation of the ARRA has already achieved a significant goal: the HIT industry is stimulated," said David Muntz, senior vice president and CIO for Baylor Health Care System in Dallas, CHIME Board of Trustees Member and co-chair of CHIME's Advocacy Initiatives. "A newfound focus on CPOE has spurred discussions at every level of our healthcare organizations, from the board to the bedside. In addition, all participants in the care delivery and wellness management environments are fully engaged in discussions about the implications of the changes which have been suggested...Our goal as CIOs is to reveal to the participants the steps and degree of effort which will be required to achieve meaningful outcomes."