Aarts Jos, Ash Joan, Berg Marc
Institute of Health Policy and Management, Erasmus University Medical Center, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
Int J Med Inform. 2007 Jun;76 Suppl 1:S4-13. doi: 10.1016/j.ijmedinf.2006.05.009. Epub 2006 Jun 23.
To describe the perceived effect of computerized physician order entry (CPOE) on professional collaboration, workflow and quality of care.
Semi-structured interviews with experts involved in the design, implementation and evaluation of computerized physician order systems in the United States.
The interview transcripts were analyzed using six key concepts that identify context, professional collaboration, workflow and quality of care.
The interviews reveal the complexity of CPOE. Although providers enter the orders, others collaborate in the decision-making process. There is a profound impact on workflow beyond that of the provider. While quality of care is the main impetus for implementation, it remains terribly difficult to measure the impact on quality.
A proper understanding of CPOE as a collaborative effort and the transformation of the health care activities into integrated care programs requires an understanding of how orders are created and processed, how CPOE as part of an integrated system can support the workflow, and how risks affecting patient care can be identified and reduced, especially during hand-offs in the workflow.
描述计算机化医嘱录入（CPOE）对专业协作、工作流程和医疗质量的感知影响。
对参与美国计算机化医嘱系统设计、实施和评估的专家进行半结构化访谈。
使用六个关键概念对访谈记录进行分析，这些概念用于确定背景、专业协作、工作流程和医疗质量。
访谈揭示了CPOE的复杂性。虽然医嘱由医护人员录入，但在决策过程中有其他人员协作。它对医护人员以外的工作流程有深远影响。虽然医疗质量是实施CPOE的主要推动力，但衡量其对质量的影响仍然非常困难。
要正确理解CPOE是一项协作努力，并将医疗活动转变为综合护理计划，需要了解医嘱是如何创建和处理的，CPOE作为综合系统的一部分如何支持工作流程，以及如何识别和降低影响患者护理的风险，尤其是在工作流程中的交接过程中。
