Ash Joan S, Fournier Lara, Stavri P Zoë, Dykstra Richard
Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
AMIA Annu Symp Proc. 2003;2003:36-40.
To identify success factors for implementing computerized physician order entry (CPOE), our research team took both a top-down and bottom-up approach and reconciled the results to develop twelve overarching principles to guide implementation. A consensus panel of experts produced ten Considerations with nearly 150 sub-considerations, and a three year project using qualitative methods at multiple successful sites for a grounded theory approach yielded ten general themes with 24 sub-themes. After reconciliation using a meta-matrix approach, twelve Principles, which cluster into groups forming the mnemonic CPOE emerged. Computer technology principles include: temporal concerns; technology and meeting information needs; multidimensional integration; and costs. Personal principles are: value to users and tradeoffs; essential people; and training and support. Organizational principles include: foundational underpinnings; collaborative project management; terms, concepts and connotations; and improvement through evaluation and learning. Finally, Environmental issues include the motivation and context for implementing such systems.
为了确定实施计算机化医师医嘱录入系统(CPOE)的成功因素,我们的研究团队采用了自上而下和自下而上的方法,并对结果进行了协调,以制定十二条总体原则来指导实施。一个专家共识小组提出了十条考量因素以及近150条子考量因素,一个为期三年的项目在多个成功案例点运用定性方法采用扎根理论方法得出了十条总体主题以及24条子主题。在使用元矩阵方法进行协调之后,出现了十二条原则,这些原则聚成几组,形成了助记符CPOE。计算机技术原则包括:时间考量;技术与满足信息需求;多维整合;以及成本。个人原则有:对用户的价值和权衡;关键人员;以及培训与支持。组织原则包括:基础支撑;协作式项目管理;术语、概念和内涵;以及通过评估和学习实现改进。最后,环境问题包括实施此类系统的动机和背景。