Abstract This paper focuses on the implementation of the Computerized Physician Order Entry System, CPOE at Brigham and Women’s Hospital in Boston, Massachusetts. It provides complete analysis of the project, targeting its strengths, weaknesses, opportunities and threats. This assessment will provide a better insight of whether continual application of CPOE is beneficial for the institution or should be restrained. CPOE implementation at Brigham and Women’s Hospital: The SWOT Analysis.Brigham and Women’s Hospital has been one of the foremost institutions in investing in the latest information technology system.
In 2004, it adopted the Computerized Physician Order Entry system, CPOE and since then it is evaluating its potentials and limitations. The CPOE is an advance technology that allows doctors, nurse practitioners and the physician’s assistants to electronically input the medications or the test orders via a computer rather than documenting it in the hand-written forms or the prescription scripts.This program has various practical applications but it also comes with the negative aspects that are also needed to be explored. This SWOT analysis will provide a deeper understanding of its implementation on the organization and the external environment (Brigham and Women’s Hospital, 2012). Strengths CPOE has been known to have several advantages.
The orders are enacted electronically which are faster, standardized and are much easier to comprehend, rather than trying to decipher perplexing handwritten scripts.Thus, this is minimizing the confusions or misinterpretations which can jeopardize the patient’s health. It also enables the doctor to assess the information from computer at the hospital facility or even through the mobile devises, allowing more flexibility in retrieving the information. The doctor merely has to enter the adequate passcode to be logged into the system to access the information (Brigham and Women’s Hospital, 2012). Moreover, the doctor can regulate the prescriptions, referrals and even order diagnostic tests, exams or labs through it for their patients.
The test schedules are also formed online. On top, doctor would be informed when that test is conducted or if any other procedures that were performed or ordered by the other physicians of that patient. All this aids in saving lot of time and the effort. It is also cost effective as the information is delivered electronically and less paperwork has to be filed or processed. The program further has a feature, called CDSS (clinical diagnostic support system) that provide tools for assessing the disease symptoms and generating the right diagnosis.Once an ordered has been executed by the physician, the system evaluates it automatically for any errors.
It sends alerts for the medication side effects, interactions and any patient allergy notifications. This information is updated to the newly FDA enforced principles and thus it promotes the safety of the patient (The LeapFrog Group, 2008). It was observed that certain adverse effects of the medications, particularly antibiotic drugs and high risk drugs, was now more effectively monitored and also any previous ill-effects were properly recorded or documented into the patient’s electronic file for easy future references.Hence the dosages, usage as well as the frequency of the drugs are regulated more carefully through it (Doolan D. & Bates D. , 2002). Although the software is equipped with CDSS feature, the physicians at Brigham and Women’s Hospital can further customize or modify this diagnosis or symptom’s checklist according to their own guidelines or practical knowledge. This way in the end, they will be making the final diagnosis (Brigham and Women’s Hospital, 2012).
All this integrated patient information and the transactions have abridged the gap and enhanced the communication between the hospital departments.The pharmacy and the labs directly receive the patient medical orders and easily interpret them; ensuing that is this is an effective approach with several advantages (WWH, 2002). Weaknesses There are few negative aspects of the CPOE. One of the disadvantages noticed is that many physicians are not inclined in investing the time to enter all the data in electronic files. These physicians appreciate the traditional approaches of paper based records with flexible alignments to enter the patient information, as it is quick and simple and would not necessitate the need for the internet and the computer.They also do not favor the diagnostic tools and instead would like to advocate their own knowledge and experience in formulating the decisions about their patient’s healthcare.
Thus, resistance is discerned from these physicians, which causes the slower adoption of this system (Doolan D. ; Bates D. , 2002). Moreover, the diagnostic decision tools insinuated by the automatic set programs can be too generalized and might not apply to the specific patients. This can lead to wrong diagnosis and incorrect medical treatments.
Also, the power cuts or the natural disasters like floods etc. can damage the computer systems and retrieval of this vital information can be difficult. All this can negatively impact the patient’s health and can cause crisis for the institution (Dr.
Kaushal R. ; Dr. Bates D.
, 2006) Another disadvantage is that the cost of implementation alone for the Brigham and Women’s Hospital is close to $1. 9 million. The annual maintenance costs have also been estimated to be around $500,000.There are various other expenses that can further contribute to the costs, like installation fees, customization or update service charges and the training expenses to educate the staff members about its application and legislature and the ethical codes (The LeapFrog Group, 2008).
Opportunities There are various opportunities for CPOE implementation and advancement within the hospital. First, it is gaining acceptance in various healthcare facilities all over the world. England, Australia, Italy, Norway, India etc. are readily adopting this program. Global support and utilization provides a “favorable environment”.It will standardize the medical processes and the documents received from other health institutions which will conform to the diagnostic criteria’s or codes of the Brigham and Women’s Hospital. This will increase proficiency by reducing confusion and swifter interpretation. Through the internet, the transfer of the data online is not only fast but very cost-effective as well (WWH, 2002).
Brigham and Women’s Hospital, has observed that the profit on the initial investment has been assessed to $5 and $10 million per year due to these cost-effective measures.In addition, because of the program’s diagnostic tools and the safety measurements, the hospital has been documented to dispense better healthcare. This will establish better relations with the patients and the federal government, stimulating the growth of the company (The LeapFrog Group, 2008).
Threats CPOE implementation carries certain risks which can substantially damage its execution in the hospital. The entire program has to conform to the intricate HIPAA laws and codes such as patient security and confidentiality matters.Failure to follow such legalities will lead to penalties, law suites and loss of confidence and trust among the patients and the other business partnerships. This will adversely affect the status of the hospital in the market.
HIPAA strongly enforce the requirement of maintaining the privacy of the patient’s information and if this security is breached or the password is reached in the hands of an unauthorized personnel, then the patient’s personal health information (PHI) can be disclosed and tempered which can wrongfully impact the healthcare of the patient.Thus, this leads to extra costs of constructing the security infringement identifiers and the training of the employees (WWH, 2002). Thus, it appears that if the weak points and the threats of the CPOE implementation are combatted, then this technology will definitely prove to be highly beneficial for the hospital and it will bring forth success and growth. References Doolan D.
& Bates D. (2002). Computerized Physician Order Entry Systems In Hospitals: Mandates And Incentives; Retrieved from: http://content. healthaffairs. org/content/21/4/180.full WWH. (2002). Information Technology (IT) and the Healthcare Industry: A SWOT Analysis; Retrieved from: http://what-when-how.
com/medical-informatics/information-technology-it-and-the-healthcare-industry-a-swot-analysis/ The LeapFrog Group. (2008). Computerized Physician Order Entry; Retrieved from: http://www. leapfroggroup. org/media/file/Leapfrog-Computer_Physician_Order_Entry_Fact_Sheet. pdf Brigham and Women’s Hospital. (2012).
CPOE: How does it work? Retrieved from: http://www. brighamandwomens. org/research/labs/cebi/introCPOE. aspx Dr.