Identification of Common Barriers and Solutions for Computerized Provider Order Entry Adoption in a Large Academic Hospital Setting
Author: David Vinh, PTA, BS
Masters thesis, The University of Texas School of Health Information Sciences at Houston.
A consulting group was formed by the administration of MH Hospital located in Houston to identify common barriers for Computerized Provider Order Entry (CPOE) adoption and possible solutions. In August 2004, the Hospital contracted with Eclipsys Technologies Corporation to implement the full suite of Eclipsys Sunrise Clinical Manager XA™ software systems, which includes CPOE. CPOE was an integral part of the system, but implementation of CPOE was known to be a complex change-management task. Numerous implementation failures were documented in the literature. For these reasons a thorough analysis of the common barriers for CPOE adoption and development of possible solutions were mandated by the Hospital’s administration. The analysis included a study of the environment of the hospital including patient volumes, staffing levels, and relevant characteristics of the medical staff. A thorough review of the literature concerning CPOE adoption practices was also conducted to determine the commonly cited barriers to adoption and candidate solutions. Using a problem statement matrix, the barriers were organized into three major categories: human barriers, organizational barriers, and technical barriers. Based on this compilation of barriers, a list of appropriate questions to be addressed by the consulting group was created. These questions were then discussed with a subject matter expert (SME) with experience in CPOE adoption. Using this input, the barriers were formulated based on the structure of the Hospital’s CPOE implementation team. Possible candidate solutions were organized and then ranked on the basis of their feasibility and urgency.