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Submitted on February 8, 2002
Accepted on March 7, 2003
Affiliation of the authors: 1 University of Washington, Seattle, WA; 2 VA Puget Sound Health Care System, Seattle, WA; 3 University Hospital, Geneva, Switzerland
* To whom correspondence should be addressed.
Objective To describe the configuration and use of the computerized provider order entry (CPOE) system used for inpatient and outpatient care at our facility.
Design Description of order configuration entities, use patterns, and configuration changes in a production CPOE system.
Measurements We extracted and analyzed the content of order configuration entities (order dialogs, pre-configured [quick] orders, order sets, and order menus) and determined the number of orders entered in our production order entry system over the previous 3 years. We measured use of these order configuration entities over a 6-month period. We repeated the extract 2 years later to measure changes in these entities.
Results CPOE system configuration, conducted before and after first production use, consisted of preparing 667 order dialogs, 5,981 pre-configured (quick) orders, and 513 order sets organized in 703 order menus for particular contexts, such as admission for a particular diagnosis. Fifty percent of the order dialogs, 57% of the quick orders, and 13% of the order sets were used within a 6-month period. Over the subsequent 2 years, the volume of order configuration entities increased by 26%.
Conclusion These order configuration steps were time-consuming, but we believe important to increase the ordering speed and acceptability of the order entry software. Lessons learned in the process of configuring our CPOE ordering system are given. Better understanding of ordering patterns may make order configuration more efficient, because many of the order configuration entities we created were not used by clinicians.
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