Implementation of Computerized Physician Order Entry in Primary Care: A Scoping Review

Abstract

Purpose This scoping review aimed to assess the implementation and outcomes of computerized physician order entry (CPOE) in primary care. Methods A scoping review was carried out in accordance with the Joanna Briggs Institute’s guidelines (JBI). The databases PubMed, CINAHL, Science Direct, and Google Scholar were all searched. The full text of each article was reviewed for eligibility after the title and abstract were evaluated. JBI data extraction were used to extract data. Donabedian’s framework served as the foundation for the data discussion. Results Based on the inclusion criteria, seven studies were included. The studies’ main goal in common was to analyze the outcome or impact of implementing CPOE systems in ambulatory or primary care settings. Several studies described the framework, current state of implementation, and evaluation or recommendation following CPOE system implementation. Many positive effects were felt by physicians or prescribers, pharmacists, patients, and primary care providers, with patient safety being the primary goal. Conclusion Although this study discovered some issues and factors associated with CPOE implementation and adoption, such as infrastructure, workflow, level of engagement, and safety culture, CPOE has many positive outcomes for patients, physicians, and primary care. To improve CPOE adoption in healthcare, particularly primary care, more research into the structure, framework, and components of CPOE deployment is required.

Adoption by clinicians of electronic order communications in NHS secondary care: a descriptive account

“…As part of an evaluation of PICS after it had recently been introduced into new areas, clinical users were asked to complete a questionnaire based on the University of Iowa post go-live perceptions survey. 21 Specifically, users were asked whether they thought communication between hospital staff and legibility and clarity of patient care orders had worsened (−3 to -2, −1), stayed the same (0) or improved [1][2][3] since PICS' introduction. An online version of the survey was created, and links were sent out to relevant staff email lists; paper copies were also distributed at staff meetings and on wards with a return box being used to ensure confidentiality and anonymity.…”

“…It may also reduce the number of staff-facilitated steps required in the request pathway 2. Despite these obvious advantages, there is some controversy over whether CPOE in practice translates into improved patient outcomes and clinician satisfaction 3. While there is some evidence that adoption of such systems results in doctors spending greater time with both their patients and peers, over time it has become apparent that CPOE systems which introduce burdensome clerical tasks may be linked to clinician burnout 4.…”

“… 2 Despite these obvious advantages, there is some controversy over whether CPOE in practice translates into improved patient outcomes and clinician satisfaction. 3 While there is some evidence that adoption of such systems results in doctors spending greater time with both their patients and peers, over time it has become apparent that CPOE systems which introduce burdensome clerical tasks may be linked to clinician burnout. 4 It is therefore important that CPOE systems are carefully implemented to facilitate communication, without requiring unnecessary clerical steps by having clinical input into the design.…”

Web-Based public health center management information system using Codeigneter and Ajax techniques at Public Health Canter

“…A computer-based health information system produces easier, quality, and more relevant information (3)(4)(5). It can support management functions and overcome the increasing complexity of health data (6,7). The health center management information system (SIMPUS) aims to produce a system that can provide service workers with the information needed for patient management (8).…”