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Int J Med Inform. 2017 Jul;103:42-48. doi: 10.1016/j.ijmedinf.2017.04.007. Epub 2017 Apr 10.

Physician satisfaction with transition from CPOE to paper-based prescription.

Author information

1
Department of Biomedical Informatics, Rouen University Hospital, F-76000 Rouen, France; TIBS, LITIS EA 4108, Normandie University, Rouen, France; INSERM, U1142, LIMICS, 75006 Paris, France; Sorbonne Universités, UPMC Univ. Paris 06 UMR_S 1142, LIMICS, 75006 Paris, France; Univ. Paris 13, Sorbonne Paris Cité, LIMICS (UMR_S 1142), 93430 Villetaneuse, France. Electronic address: nicolas.griffon@chu-rouen.fr.
2
Department of Biomedical Informatics, Rouen University Hospital, F-76000 Rouen, France; TIBS, LITIS EA 4108, Normandie University, Rouen, France; Department of General Practice, Rouen University, France.
3
Department of Biomedical Informatics, Rouen University Hospital, F-76000 Rouen, France; TIBS, LITIS EA 4108, Normandie University, Rouen, France.
4
Department of Statistics, Rouen University Hospital, F-76000 Rouen, France.
5
Department of Biomedical Informatics, Rouen University Hospital, F-76000 Rouen, France; TIBS, LITIS EA 4108, Normandie University, Rouen, France; INSERM, U1142, LIMICS, 75006 Paris, France; Sorbonne Universités, UPMC Univ. Paris 06 UMR_S 1142, LIMICS, 75006 Paris, France; Univ. Paris 13, Sorbonne Paris Cité, LIMICS (UMR_S 1142), 93430 Villetaneuse, France.

Abstract

INTRODUCTION:

In January 2015, Rouen University Hospital's information system experienced serious issues. It was necessary to rapidly switch from the computerized provider order entry (CPOE) system towards a paper-based order entry (PBOE) system. This was an opportunity to evaluate prescriber opinion on the two provider order entry (POE) systems.

METHODS:

All residents were asked to fill an augmented version of the POE satisfaction and usage survey for both POE systems. The results were compared to identify the strengths and weaknesses of each system.

RESULTS:

Fifty-one respondents had used the CPOE system and the PBOE system. Overall, satisfaction was higher with PBOE than CPOE (odds ratio (OR)=3.74; p<0.001). Usability (OR=4.00; p<0.001), reliability (OR=8.54; p<0.001), time consumption (OR=0.50; p<0.05 - survey statement was formulated negatively), and communication with nurses (OR=14.27; p<0.0001) reached statistically better agreement. The more experience with CPOE the more residents were disillusioned with the reliability (OR=6.55; p<0.01), the usability (OR=5.68; p<0.01) and the patient safety (OR=0.27; p<0.05 - survey statement was formulated negatively) of CPOE. Although safety issues were reported for both systems, the causes were different; PBOE imposed frequent rewriting of the order while CPOE lack of usability might be unsafe. Another important issue with both POE systems was time consumption.

CONCLUSION:

Residents did not report any increase in safety issues with the rapid switch from CPOE to PBOE. They even seemed more satisfied with the rollback to paper, which remains a possible degraded mode in case of health information technology collapse.

KEYWORDS:

Cross-sectional studies; Medical order entry systems; Qualitative research

PMID:
28551000
DOI:
10.1016/j.ijmedinf.2017.04.007
[Indexed for MEDLINE]

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