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June 7, 2013
For immediate release
Islanders to benefit from enhancements to provincial Electronic Health Record
Island hospitals are implementing a new electronic ordering process – called CPOE (Computerized Provider Order Entry) – that will see hand-written physician orders replaced by electronic orders, further enhancing the province’s Electronic Health Record (EHR) system, says Dr. Tim Fitzpatrick, CPOE and Clinical Informatics Physician for Health PEI.
“We are excited for the improved efficiencies and patient safety that CPOE will bring to patient care,” said Dr. Fitzpatrick. “This new electronic ordering process is a critical component of the provincial Electronic Health Record and will afford our health care providers the opportunity to standardize safer patient care practice on a variety of levels, better support clinical decisions and make patient transfers easier.”
Over the next year all Island hospitals will begin using this new electronic ordering process to order diagnostic tests, order and chart medications, and enter patient care instructions directly into the patient’s Electronic Health Record at the time of care.
CPOE is another step Health PEI is taking to make the provincial Electronic Health Record more complete and integrated for all Islanders. It will benefit patients – as well as physicians and health care providers – by:
• delivering real-time patient information that will allow health care staff to make decisions that provide the most effective and safest care for their patients;
• reducing errors that can occur when orders are written by hand; and
• improving patient safety by alerting health care providers of medication conflicts, allergies, and similar tests already ordered.
Prince County Hospital is the first facility to implement CPOE, having gone live on June 1, successfully launching the new process throughout the hospital. The Queen Elizabeth Hospital (QEH) will implement CPOE later this fall, with Hillsborough and community hospitals following suit in the spring of 2014.
"CPOE implementation is an important milestone in the completion of our integrated Electronic Health Record,” said Dr. Scott Cameron, Chief of Emergency Medicine at PCH. “The staff at PCH are working hard at making this phase of implementation as smooth as possible. Changes of any kind are difficult and I am proud of the dedication of the physicians, nurses and other health care staff across our hospital in adapting to these process changes for the benefit of patient safety and for documentation clarity."
Implementing CPOE impacts a hospital’s in-patient, surgical and emergency department services. The public is asked to be patient with physicians and staff as they adapt to this new process.
For more information on the Electronic Health Record or CPOE, visit www.healthpei.ca/ehr.
Prince Edward Island is working with federal, provincial and other stakeholders to implement and evolve integrated Electronic Health Records (EHR) across the province.
An EHR is a secure, integrated and comprehensive view of a person’s health information generated by their interactions with the healthcare system. This information is available to authorized healthcare providers when and where they need it, increasing the quality and safety of care received by every Islander accessing the health system.
This important initiative supports Health PEI’s goal of "One Island Health System" as well as the long-term sustainability of healthcare delivery on Prince Edward Island.
The major installed components of the province’s EHR are:
• Clinical Information System (CIS) – The cornerstone of the province’s EHR, the CIS provides seamless, real-time exchange of clinical information between all Island hospitals. It was launched in 2008 and was completed in March 2011.
• Computerized Provider Order Entry (CPOE) – A robust order management system which allows clinicians to electronically process various types of orders. Electronic ordering has been implemented province-wide for laboratory, diagnostic imaging and allied health consult orders. CPOE enables faster, more efficient, and safer care for Islanders.
• Drug Information System (DIS) – The first of its kind in Canada, our province’s DIS contains information relating to medications prescribed for Islanders and provides Island pharmacists and other authorized healthcare providers with province-wide access to medication profiles.
• Picture Archive and Communication System (PACS) – PACS enables the digital capture, storage and distribution of medical images. A diagnostic image such as an X-ray can be captured and shared in real-time with authorized healthcare providers across the province.
• Radiology Information System (RIS) – RIS manages all diagnostic imaging-related patient information across PEI. An X-ray taken at one of our community hospitals, for example, can be interpreted by a radiologist either locally or remotely and as soon as she/he finishes the report, it is immediately available electronically to all authorized healthcare providers across PEI.
• Client Registry (CR) – CR serves as the definitive source of patient/client demographic and administrative information. CR shares this information with other components of the EHR as needed.
Q&A - CPOE:
Q: What is CPOE?
A: “CPOE” stands for Computerized Provider Order Entry. As part of the Clinical Information System (CIS), CPOE automates the ordering process in hospitals for diagnostic tests (laboratory and diagnostic imaging), medications, and patient care instructions to nursing, and other health care providers, by ordering clinicians (primarily physicians). Nursing will also use the system to chart when medication was given as well as to document the care provided to patients.
Q: Why is Health PEI implementing CPOE?
A: CPOE is a strategic initiative of Health PEI, and the health care system, in support of quality, safety and improved patient care. CPOE gives health care organizations the opportunity to standardize practice; incorporate clinical decision support into daily practice; improve inter-departmental communications; facilitate patient transfers; and capture data for management, research and quality monitoring. CPOE is more appropriate to the complexities of today’s healthcare than paper based systems.
Q: How does CPOE fit with the rest of the electronic health record?
A: CPOE is another step towards the achievement of the goal of “one patient, one record” and in the evolution of an integrated electronic health record for all Islanders.
Q: What are the features of CPOE?
A: CPOE is being implemented in two phases.
Phase 1 included replacing paper requisitions for lab, diagnostic imaging and allied health consults for hospital in-patients, emergency and surgical department patients. Nursing departments electronically enter these orders into the CIS. CPOE Phase 1 has been implemented in all Island hospitals.
Phase 2 is comprised of two components: 1) ordering clinicians, primarily physicians, will stop writing orders on paper and will begin entering orders, including lab, diagnostic imaging, consults, as well as medication and patient care orders, electronically into the CIS; and, 2) nursing will use CPOE to chart when medication was given as well as the care they provided to their patients. This phase of CPOE will be implemented in a phased approach, commencing with Prince County Hospital (PCH) June 1st, 2013.
Q: What are the benefits of CPOE?
A: Major benefits of CPOE include:
• Reduction in medical errors associated with handwriting, transcription, abbreviations, differing units of measure and look-alike, sound-alike drug names;
• Standardized, safer patient care enabled by drug-to-drug interaction and duplicate checking as well as drug allergy checking;
• Workflow and efficiency gains through the removal of order processing time which will allow for faster initiation of treatment ; and,
• The delivery of real-time patient information to the prescribing clinician at the point of care.
Q: How will CPOE benefit hospitals?
A: CPOE affords hospitals the opportunity to standardize clinical processes and clinical decision support used in daily practice by clinicians while caring for patients. CPOE also assists in improving inter-departmental communication, facilitates patient transfers, and captures data for management, research and quality monitoring.
Q: How will CPOE improve patient safety?
A: CPOE is about improving patient care and patient safety.
• Orders entered in a computer are easier to read than handwritten orders, reducing the chance of errors.
• If two drugs being ordered for a patient should not be used together, the system will give the physician a warning at the time the physician is entering the order into the system.
• If the patient has an allergy to the drug the physician is ordering, the system will give the physician a warning at the time the physician is entering the order into the system.
• The duplicate warning will alert the physician or nurse that similar drugs/tests have already been ordered so they will not be ordered twice by mistake nor will they be unnecessarily repeated.
• Physicians, nurses and other health care providers will have information at their fingertips to assist them in making decisions about patient care.
Q: Where is CPOE being implementing and when?
A: All seven (7) Island hospitals are implementing both phases of CPOE. To date, all have implemented the first phase of CPOE.
On June 1st, 2013, Prince County Hospital (PCH) will be the first Island hospital to implement the second phase of CPOE. The Queen Elizabeth Hospital (QEH) will be implementing CPOE Phase 2 later this fall and the remaining Island hospitals will begin implementation in the new year.