Implementation of Computerized Prescriber Order Entry Systems: A Review of Impacts, Barriers, and Facilitators

Abstract

Objective: This review evaluated the impact of a digitized computerized prescriber order entry (CPOE) system and described barriers and facilitators for introducing a digitized system. Data Sources: A systematic literature search was conducted in PubMed, Medline, and CINAHL using keywords. Articles in English during the last 10 years were included. Study Selection and Data Extraction: Study selection was presented using a PRISMA flow diagram. Forty-eight studies were included. Data from the articles were presented to address each of the three objectives. Data Synthesis: CPOE systems improved the quality of care provided but also introduced new types of errors. Facilitating factors for implementation included leadership, stakeholder engagement, training, and user-centered design. Inadequate training, software design, changes in workload, and workflow disruptions were identified as barriers. Recommendations for implementation included dedicated training of users, user-centered design, a backup for system downtimes, and stakeholder engagement. Conclusion: Application of knowledge of the facilitators and barriers for the introduction of a CPOE system supports this change-management process within the specific context and augurs for more successful implementation.