Computerized physician order entry isn’t exactly New Coke or the Edsel, but CPOE adoption remains low, with fewer than one in six U.S. hospital employees actually using CPOE systems.
The history of CPOE dates back to the mid-1960s, with the first system developed by what, today, is aerospace and defense firm Lockheed Martin. Commercially available CPOE systems didn’t really emerge until the 1990s.
Critically, most CPOE systems were developed for hospitals, not physicians — they don’t incorporate clinical decision support (or do so badly), they’re too closely tied to hospital information systems and they can’t be used on the smartphones and tablet PCs on which physicians increasingly rely.
CPOE adoption in Europe seems to be picking up, due largely to its incorporation into other health information technology initiatives. Of course, it is hoped that the same will be true in the United States, where, under meaningful use, CPOE systems must be used for 30% of all orders by stage 1, 60% of all orders by stage 2 and 80% by stage 3.
If history is any guide, though, functionality will have to improve before adoption rises. In addition, CPOE implementation should be simplified, with fewer stakeholders, fewer meetings and fewer wholesale changes. The notion of cutting red tape should appeal to any physician.