An Electronic Health Record Order Entry-Enabled Educational Intervention Is Not Effective in Reducing STAT Inpatient Radiology Orders

Trinh, Tony W.; Ip, Ivan K.; Healey, Michael; Landman, Adam B.; Morris, Charles A.; Boland, Giles W.; Khorasani, Ramin

doi:10.1016/j.jacr.2019.01.033

Cited by 1 publication

(1 citation statement)

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“…EHRs support multiple healthcare functions, including creation and storage of patient notes, managing electronic prescriptions and patient-facing web portals 3. Widening access to EHRs is also driving greater adoption of computerised provider order entry (CPOE) systems, which are used by healthcare workers (HCWs) to submit diverse electronic requests, ranging from laboratory investigations,4–14 to imaging studies and radiological examinations,15–22 to health education videos,3 to drugs and medications 1 2 23–25. The proportion of hospitals using CPOE is not known 5.…”

Section: Introductionmentioning

confidence: 99%

Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis

et al. 2023

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IntroductionRelevant clinical information is vital to inform the analytical and interpretative phases of most investigations. The aim of this study is to evaluate the impact of implementation of computerised provider order entry (CPOE), featuring order-specific electronic order entry forms (eOEFs), on the quality and quantity of clinical information included with investigation requests.MethodsThe CPOE module of a commercially available electronic health record (Cerner Millennium) was implemented at a large, tertiary care centre. The laboratory information management system was interrogated to collect data on specimens sent for microbiological culture 1 year before implementation of CPOE (2018), immediately post implementation (2019) and 6 months post implementation (2020). An interrupted time series analysis was performed, using text mining, to evaluate the quality and quantity of free-text clinical information.ResultsIn total, 39 919 specimens were collected from 16 458 patients. eOEFs were used to place 10 071 out of 13 735 orders in 2019 (73.3%), and 9155 out of 12 229 orders in 2020 (74.9%). No clinical details were included with 653 out of 39 919 specimens (1.6%), of which 22 (3.4%) were ordered using eOEFs. The median character count increased from 14 in 2018, to 41 in 2019, and 38 in 2020. An anti-infective agent was specified in 581 out of 13 955 requests (4.2%) in 2018; 5545 out of 13 735 requests (40.4%) in 2019; and 5215 out of 12 229 requests (42.6%) in 2020. Ciprofloxacin or piperacillin-tazobactam (Tazocin) were mentioned in the clinical details included with 421 out of 15 335 urine culture requests (2.7%), of which 406 (96.3%) were ordered using eOEFs. Subsequent detection of in vitro non-susceptibility led to a change in anti-infective therapy for five patients.ConclusionsImplementation of CPOE, featuring order-specific eOEFs, significantly and sustainably improves the quality and quantity of clinical information included with investigation requests, resulting in changes to patient management that would not otherwise have occurred.

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