What effect does electronic ordering have on the organisational dynamics of a hospital pathology service?

The aim of this triangulated (multi-method, multi-setting, multi-staged) study was to identify the consequences of an electronic ordering system on the functioning and organisational dynamics of a hospital pathology service. The study was carried out in five pathology departments during the period August 2005 to April 2006. It included five focus groups involving 21 participants and 67 interviews with 38 participants, along with a total of 21 hours of observation. The findings revealed three key themes with implications for the functioning and organisational dynamics of the pathology service. These included: a) work process changes that affect the output of the pathology laboratories; b) temporal considerations, particularly as they related to efficiency of laboratory processes; and c) communication channels and the resulting changes in the mode of information exchange and communication. These themes emerged from a close analysis of the contextual setting of each department. Successful CPOE implementation should be premised on a solid understanding of the organisational, communication, information and temporal circumstances in which the system will operate.