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'''Medical order entry systems''', also called '''computerized provider order entry systems''' ('''CPOE''') are  a component of an [[electronic health record]] and are defined as "information systems, usually computer-assisted, that enable providers to initiate medical procedures, prescribe medications, etc. These systems support medical decision-making and error-reduction during patient care."<ref>{{MeSH|Medical order entry systems}}</ref>
'''Medical order entry systems''', also called '''computerized provider order entry systems''' ('''CPOE''') are  a component of an [[electronic health record]] and are defined as "information systems, usually computer-assisted, that enable providers to initiate medical procedures, prescribe medications, etc. These systems support medical decision-making and error-reduction during patient care."<ref>{{MeSH|Medical order entry systems}}</ref>  


In the [[United States]], the CPOE of the [[United States Veterans Health Administration|Veterans Health Administration]], called VISTA/CPRS supports 'order dialogs', 'quick orders', and 'order sets'.<ref name="pmid12668686">{{cite journal |author=Payne TH, Hoey PJ, Nichol P, Lovis C |title=Preparation and use of preconstructed orders, order sets, and order menus in a computerized provider order entry system |journal=J Am Med Inform Assoc |volume=10 |issue=4 |pages=322–9 |year=2003 |pmid=12668686 |pmc=181982 |doi=10.1197/jamia.M1090 |url=http://www.jamia.org/cgi/pmidlookup?view=long&pmid=12668686 |issn=}}</ref>
In the [[United States of America]], the CPOE of the [[United States Veterans Health Administration|Veterans Health Administration]], called VISTA/CPRS supports 'order dialogs', 'quick orders', and 'order sets'.<ref name="pmid12668686">{{cite journal |author=Payne TH, Hoey PJ, Nichol P, Lovis C |title=Preparation and use of preconstructed orders, order sets, and order menus in a computerized provider order entry system |journal=J Am Med Inform Assoc |volume=10 |issue=4 |pages=322–9 |year=2003 |pmid=12668686 |pmc=181982 |doi=10.1197/jamia.M1090 |url=http://www.jamia.org/cgi/pmidlookup?view=long&pmid=12668686 |issn=}}</ref>


CPOE can be used as a type [[clinical decision support system]] whose benefits can be shown in a [[randomized controlled trial]]<ref name="pmid15758007">{{cite journal |author=Kucher N, Koo S, Quiroz R, ''et al'' |title=Electronic alerts to prevent venous thromboembolism among hospitalized patients |journal=N. Engl. J. Med. |volume=352 |issue=10 |pages=969–77 |year=2005 |month=March |pmid=15758007 |doi=10.1056/NEJMoa041533 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=15758007&promo=ONFLNS19 |issn=}}</ref> and other studies<ref name="pmid19390110">{{cite journal |author=Schedlbauer A, Prasad V, Mulvaney C, ''et al.'' |title=What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior? |journal=J Am Med Inform Assoc |volume=16 |issue=4 |pages=531–8 |year=2009 |pmid=19390110 |doi=10.1197/jamia.M2910 |url=http://www.jamia.org/cgi/pmidlookup?view=long&pmid=19390110 |issn=}}</ref><ref name="pmid16357360">{{cite journal |author=Ozdas A, Speroff T, Waitman LR, Ozbolt J, Butler J, Miller RA |title=Integrating "best of care" protocols into clinicians' workflow via care provider order entry: impact on quality-of-care indicators for acute myocardial infarction |journal=J Am Med Inform Assoc |volume=13 |issue=2 |pages=188–96 |year=2006 |pmid=16357360 |pmc=1447538 |doi=10.1197/jamia.M1656 |url=http://www.jamia.org/cgi/pmidlookup?view=long&pmid=16357360 |issn=}}</ref>.
CPOE can be used as a type [[clinical decision support system]] whose benefits can be shown in a [[randomized controlled trial]]<ref name="pmid15758007">{{cite journal |author=Kucher N, Koo S, Quiroz R, ''et al'' |title=Electronic alerts to prevent venous thromboembolism among hospitalized patients |journal=N. Engl. J. Med. |volume=352 |issue=10 |pages=969–77 |year=2005 |month=March |pmid=15758007 |doi=10.1056/NEJMoa041533 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=15758007&promo=ONFLNS19 |issn=}}</ref> and other studies<ref name="pmid19390110">{{cite journal |author=Schedlbauer A, Prasad V, Mulvaney C, ''et al.'' |title=What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior? |journal=J Am Med Inform Assoc |volume=16 |issue=4 |pages=531–8 |year=2009 |pmid=19390110 |doi=10.1197/jamia.M2910 |url=http://www.jamia.org/cgi/pmidlookup?view=long&pmid=19390110 |issn=}}</ref><ref name="pmid16357360">{{cite journal |author=Ozdas A, Speroff T, Waitman LR, Ozbolt J, Butler J, Miller RA |title=Integrating "best of care" protocols into clinicians' workflow via care provider order entry: impact on quality-of-care indicators for acute myocardial infarction |journal=J Am Med Inform Assoc |volume=13 |issue=2 |pages=188–96 |year=2006 |pmid=16357360 |pmc=1447538 |doi=10.1197/jamia.M1656 |url=http://www.jamia.org/cgi/pmidlookup?view=long&pmid=16357360 |issn=}}</ref>.


CPOE is one of the four recommendations by the [http://www.leapfroggroup.org/ Leapfrog Group].<ref>{{cite web |url=http://www.leapfroggroup.org/about_us/leapfrog-factsheet |title=The Leapfrog Group Fact Sheet |accessdate=2007-11-01 |format= |work=}}</ref>
CPOE is one of the four recommendations by the [http://www.leapfroggroup.org/ Leapfrog Group].<ref>{{cite web |url=http://www.leapfroggroup.org/about_us/leapfrog-factsheet |title=The Leapfrog Group Fact Sheet |accessdate=2007-11-01 |format= |work=}}</ref>
Since [[nursing|nurses]] will be a major consumer of CPOE output, any successful system will be consistent with [[nursing workflow]].
Order sets can reduce variability in clinic decision making<ref name="pmid21422099">{{cite journal| author=Munasinghe RL, Arsene C, Abraham TK, Zidan M, Siddique M| title=Improving the utilization of admission order sets in a computerized physician order entry system by integrating modular disease specific order subsets into a general medicine admission order set. | journal=J Am Med Inform Assoc | year= 2011 | volume= 18 | issue= 3 | pages= 322-6 | pmid=21422099 | doi=10.1136/amiajnl-2010-000066 | pmc=PMC3078659 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21422099  }} </ref>, but the use of order sets depends on physician and other factors<ref name="pmid16169772">{{cite journal| author=McAlearney AS, Chisolm D, Veneris S, Rich D, Kelleher K| title=Utilization of evidence-based computerized order sets in pediatrics. | journal=Int J Med Inform | year= 2006 | volume= 75 | issue= 7 | pages= 501-12 | pmid=16169772 | doi=10.1016/j.ijmedinf.2005.07.040 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16169772  }} </ref>.
Specific benefits of order sets include:<ref name="pmid22891236">{{cite journal| author=Avansino J, Leu MG| title=Effects of CPOE on provider cognitive workload: a randomized crossover trial. | journal=Pediatrics | year= 2012 | volume= 130 | issue= 3 | pages= e547-52 | pmid=22891236 | doi=10.1542/peds.2011-3408 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22891236  }} </ref>
* Reducing cognitive load of the clinician


==References==
==References==
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Medical order entry systems, also called computerized provider order entry systems (CPOE) are a component of an electronic health record and are defined as "information systems, usually computer-assisted, that enable providers to initiate medical procedures, prescribe medications, etc. These systems support medical decision-making and error-reduction during patient care."[1]

In the United States of America, the CPOE of the Veterans Health Administration, called VISTA/CPRS supports 'order dialogs', 'quick orders', and 'order sets'.[2]

CPOE can be used as a type clinical decision support system whose benefits can be shown in a randomized controlled trial[3] and other studies[4][5].

CPOE is one of the four recommendations by the Leapfrog Group.[6]

Since nurses will be a major consumer of CPOE output, any successful system will be consistent with nursing workflow.

Order sets can reduce variability in clinic decision making[7], but the use of order sets depends on physician and other factors[8].

Specific benefits of order sets include:[9]

  • Reducing cognitive load of the clinician

References

  1. Anonymous (2024), Medical order entry systems (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Payne TH, Hoey PJ, Nichol P, Lovis C (2003). "Preparation and use of preconstructed orders, order sets, and order menus in a computerized provider order entry system". J Am Med Inform Assoc 10 (4): 322–9. DOI:10.1197/jamia.M1090. PMID 12668686. PMC 181982. Research Blogging.
  3. Kucher N, Koo S, Quiroz R, et al (March 2005). "Electronic alerts to prevent venous thromboembolism among hospitalized patients". N. Engl. J. Med. 352 (10): 969–77. DOI:10.1056/NEJMoa041533. PMID 15758007. Research Blogging.
  4. Schedlbauer A, Prasad V, Mulvaney C, et al. (2009). "What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior?". J Am Med Inform Assoc 16 (4): 531–8. DOI:10.1197/jamia.M2910. PMID 19390110. Research Blogging.
  5. Ozdas A, Speroff T, Waitman LR, Ozbolt J, Butler J, Miller RA (2006). "Integrating "best of care" protocols into clinicians' workflow via care provider order entry: impact on quality-of-care indicators for acute myocardial infarction". J Am Med Inform Assoc 13 (2): 188–96. DOI:10.1197/jamia.M1656. PMID 16357360. PMC 1447538. Research Blogging.
  6. The Leapfrog Group Fact Sheet. Retrieved on 2007-11-01.
  7. Munasinghe RL, Arsene C, Abraham TK, Zidan M, Siddique M (2011). "Improving the utilization of admission order sets in a computerized physician order entry system by integrating modular disease specific order subsets into a general medicine admission order set.". J Am Med Inform Assoc 18 (3): 322-6. DOI:10.1136/amiajnl-2010-000066. PMID 21422099. PMC PMC3078659. Research Blogging.
  8. McAlearney AS, Chisolm D, Veneris S, Rich D, Kelleher K (2006). "Utilization of evidence-based computerized order sets in pediatrics.". Int J Med Inform 75 (7): 501-12. DOI:10.1016/j.ijmedinf.2005.07.040. PMID 16169772. Research Blogging.
  9. Avansino J, Leu MG (2012). "Effects of CPOE on provider cognitive workload: a randomized crossover trial.". Pediatrics 130 (3): e547-52. DOI:10.1542/peds.2011-3408. PMID 22891236. Research Blogging.