If you had to begin implementing computerized physician order entry (CPOE) today, how many years do you think it would take for you to reach 100% adoption? This was one of several questions that the College of Healthcare Information Management Executives posed to 335 of its CIO members in a June CPOE survey.
Of the 316 respondents who answered the question, only 8.5% of the respondents said full adoption could be achieved in a year. More than a third (34.5%) of respondents estimated a three-year timeframe.
These survey results hint at the challenges that many hospitals hoping to take full advantage of the EHR incentives outlined in ARRA are facing. Providers must implement CPOE for "all order types, including medication [inpatient and outpatient]" by 2011, according to the proposed meaningful use matrix that the Health Information Technology Policy Committee released last month. The specific measure that hospitals must report is the percentage of orders entered directly by physicians through CPOE.
And it all goes back to the very first goal outlined in the matrix: improve quality, safety, and efficiency of healthcare as well as reduce health disparities. The idea is that CPOE will help to get the ball rolling toward many of these important patient care goals.
But despite the Office of the National Coordinator (ONC) for Health Information Technology's good intentions, the American Hospital Association, Federation of American Hospitals, and Association of Medical Directors of Information Systems, and other organizations have each expressed concerns regarding the 2011 deadline, stating that it may be too soon in the timeline to implement this technology that is fraught with potential unintended consequences.
A CPOE implementation is one that providers definitely don't want to rush, says Allison Viola, MBA, RHIA, director of federal relations for the American Health Information Management Association (AHIMA) in Washington DC. "It's going to take a very dedicated and careful approach because it is a very high-risk implementation," she adds.