Singh Dushyant, Spiers Sue, Beasley Brent W
University of Missouri-Kansas City, Kansas City, 66218, USA.
South Med J. 2011 Jun;104(6):418-21. doi: 10.1097/SMJ.0b013e31821a7f80.
Computerized Physician Order Entry (CPOE) has the potential to decrease medical errors and improve quality. Our health system plans to implement CPOE in response to the ARRA HITECH Act.
To determine (A) physicians' projections of the most important characteristics of a CPOE system that will affect their willingness to adopt CPOE, and (B) the obstacles they foresee in adopting CPOE.
All members of our health system's physician quality organization were invited to participate in a confidential survey.
Two hundred twenty-four of 549 (41%) recipients responded to the survey. Respondents ranked "disruption in my work routine" (72%) and "improve efficiency in placing orders" (63%) as the two most important characteristics that would affect their utilization of CPOE. They believed CPOE would enable orders to be placed more efficiently (3.3, sd = 1.2), carried out rapidly (3.4, sd = 0.9), and have fewer errors (3.7, sd = 0.9). The most commonly cited obstacles to CPOE implementation were: Efficiency-Inefficiency (23%), Hardware Availability (12.7%), Computer Restrictions (10.8%), Training (8.8%), Simplicity - Ease of Use (8.5%), and Physician Buy-in (8.1%).
The majority of physicians believed CPOE would lead to a reduction of medical errors and more efficient patient care. However, physicians are highly concerned with how CPOE will affect their own work efficiency.
计算机化医生医嘱录入系统（CPOE）有降低医疗差错并提高医疗质量的潜力。我们的医疗系统计划根据《美国复苏与再投资法案》（ARRA）的《健康信息技术经济和临床健康法案》（HITECH）实施CPOE。
确定（A）医生对影响其采用CPOE意愿的CPOE系统最重要特征的预测，以及（B）他们在采用CPOE时预见的障碍。
邀请我们医疗系统医生质量组织的所有成员参与一项保密调查。
549名受邀者中有224名（41%）回复了调查。受访者将“打乱我的日常工作”（72%）和“提高下单效率”（63%）列为影响他们使用CPOE的两个最重要特征。他们认为CPOE能使医嘱下达更高效（3.3，标准差 = 1.2）、执行迅速（3.4，标准差 = 0.9）且差错更少（3.7，标准差 = 0.9）。实施CPOE最常被提及的障碍有：效率低下（23%）、硬件可用性（12.7%）、计算机限制（10.8%）、培训（8.8%）、简单易用性（8.5%）以及医生的接受度（8.1%）。
大多数医生认为CPOE将减少医疗差错并提高患者护理效率。然而，医生高度关注CPOE将如何影响他们自身的工作效率。
