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Involving Users in the Implementation of an Imaging Order Entry System

Affiliations of the authors: Department of Radiology, Division of Nuclear Medicine, Emory University Hospital, Atlanta, Georgia (DMS); Surgery Service, Asheville, NC VA Medical Center, Asheville, North Carolina (SEH); Information Resource Management, Asheville, NC VA Medical Center, Asheville, North Carolina (CBC, DSS); Imaging Support Team, Asheville, NC VA Medical Center, Asheville, North Carolina (KYK).

Correspondence and reprints: David M. Schuster, MD, Emory University Hospital, Division of Nuclear Medicine, Department of Radiology, 1364 Clifton Road, NE, Room E-145, Atlanta, GA 30322; e-mail: <david_schuster{at}emoryhealthcare.org>.

Received for publication: 08/20/02; accepted for publication: 03/04/03.

Physician order entry is a powerful function of a computerized hospital information system. Although designed to be clinician-driven, the imaging section of the order entry system may not be designed optimally to engage the clinician with imaging procedures logically organized for the clinician's typical work patterns. There also may be resistance among overburdened clinicians in having to take the time to learn a new computer system and to assume "clerk's duties" of entering imaging orders. A potential means to address clinician opposition is to cooperatively engage each clinical service in the design of an imaging order entry system with customized menus for each service. This article reports a step-by-step process for the implementation of an imaging order entry system with specialized menus for an orthopedic service. This implementation process includes (1) identification of key personnel, (2) familiarization with the system, (3) discussion and dialogue between key personnel, (4) addressing specific problems, (5) education and orientation of the target group, (6) initial implementation, (7) feedback and improvement, (8) demonstration project (time study) to foster acceptance, and (9) ongoing enhancement.

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