Hi Cindy,

We started with CPOE in an accidental way. In 2001 when we went up with POM for 
the non-providers, the providers decided they wanted to do it too and it took 
off.

While that sounds grand, it was a bit of a nightmare and has had some outcomes 
that we would like others to avoid.  At this point, many have since stepped 
back from entering orders. This was due in part to earlier versions of the 
system not handling the paper requisitions well when the orders were stopped by 
a provider and to other cultural issues.

We have discussed that had we to do this again we would have chosen to have 
small groups coming up at staggered times.  This will allow for adequate 
support for the newest users and allow for the processes to get ironed out as 
well.  Nothing iritates the providers more than the other users around them not 
knowing the processes. 

As for running paper and system together, it is messy but it can be done. We 
have moved to having all orders entered on the system by non-providers from the 
written orders.  Patient Order Summaries are printed each night for the record. 
 Lots of paper and duplicate efforts but everything is there to slog through, 
and they do have to slog through it. This cumbersome approach is helping them 
to embrace getting everyone on line together :-)  

We are currently not on AOM or EDM so continue from ambulatory is not an option 
for us.  We are looking at the Transfer routine for the orders handled pre and 
post op.  Haven't finished working that routine through yet.  The routine looks 
fairly straight forward, it will be the process changes needed that are the 
sticking point I am sure.

Lessons learned from the first go round, make sure that everyone in the 
vicinity of the ordering providers knows how to place orders in POM.  If they 
have to call someone or walk to another location to ask for help in placing a 
chest xray order, they will not be happy.  Also, ensure that there is 
assistance from folks who can help them with their Favorites and Favorite Order 
Sets.  Providers who learn to use those won't give them up and find them a time 
saver.

Best of luck and Happy Thanksgiving.
Teri

Teri R. Young-Hise, RN,C
Clinical Systems Analyst
Pen Bay Healthcare
Rockport, ME 
(207) 596-8217
[EMAIL PROTECTED]


>>> "Grolla, Cindy" <[EMAIL PROTECTED]> 11/19/06 04:42PM >>>

I have questions for any sites that are LIVE with CPOE.  We are a C/S site, 
5.5, SR2.  We are planning to implement CPOE very soon and we are questioning 
our decision to implement with a pilot group of doctors vs everyone all at 
once.  At the MUSE conference there was a site that presented and they 
implemented with everyone at once and it worked well - so we are having second 
thoughts.

Here are my questions:

1.  Did you implement with a few pilot doctors?  or all doctors?

2. If you did pilot doctors how did you handle some orders being on-line and 
some written, like when a consulting doctor sees the patient

3. How did you handle the many medication orders - since the "continue from 
ambulatory" does not work at all for profile medications.  It can take a very 
long time to enter 15-20 meds - some of which are non-formulary meds for us.

4. What are any lessons learned with your implementation plans?

Any information will be greatly appreciated.  I found out so much information 
at MUSE - but still have many more.  We would also love to discuss your 
implementation if anyone is interested in a call.

thanks,
Cindy Grolla, RN
Clinical Project Leader
Phone: 507.646.1209
Pager: 507.645.1475





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