CAMBRIDGE, Mass. -- Ed Ricks, CIO at Beaufort (S.C.) Memorial Hospital, has one piece of advice for his peers struggling to get computerized physician order entry systems online to enable CPOE meaningful use compliance: Pay a group of physicians to test the system before you roll it out in your facility.
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To get the ball rolling on a Meditech Inc. CPOE implementation at the 197-bed hospital four years ago, Beaufort hired a half-time chief medical information officer and relied on a volunteer advisory council that included physicians. They customized the CPOE system -- designing workflows, assembling order sets and reducing unnecessary clicks -- to Beaufort's environment of care. But only in theory -- the system was still unproven in practice.
"[The volunteer committee] all sounded really good when there was a free dinner once a quarter to talk about things. But when it came down to the work and what we do, I just really couldn't get engagement," said Ricks, speaking at Imprivata Inc.'s HealthCon 2012 user conference.
Yet despite that indifference on the part of Beaufort's physicians, there was still testing that needed to be done. "A quote I had from one of the doctors was, 'We don't want to debug your system while we're taking care of patients,'" Ricks said. That made sense to him, so he hired a group of 14 physicians to test Beaufort's CPOE setup for a few hours at the end of their shifts or on their days off. The physicians willingly agreed.
A quote I had from one of the doctors was, 'We don't want to debug your system while we're taking care of patients.'
CIO, Beaufort Memorial Hospital
Between tests, the IT staff ironed out the rough edges in the CPOE implementation until it was ready to go live. While the small amount of money Ricks offered "wasn't very much to the physicians," he said, it signified that their contributions had a certain value in a way that that volunteer attaboys couldn't.
While this idea for testing the CPOE setup might seem obvious, it wasn't. In fact, it was more effort than the vendor itself put into physician testing. Ricks, who calls Meditech a "comprehensive, good-value system," sits on the company's customer advisory board. He went to a meeting earlier this year, and was nonplussed when Meditech revealed it recently hired 10 physicians part-time to test applications in development.
"They were so proud," Ricks said. "I said, 'I'm sorry, I'm a 200-bed hospital and I pay a group of 14 physicians part-time to help us implement our one little hospital, and it's the most valuable money I ever spent.'"
Ricks advised that attendees at the conference who are in the process of implementing a CPOE system, when possible, consult other groups who will be using the system, not just physicians. In the case of Beaufort, that meant checking in with respiratory therapists, dietitians and nursing staff to evaluate how the CPOE system performed according to their needs. Specifically, it should be determined how easy it is for those groups to access the data they need to perform their care tasks, because it's often different data than what physicians need.