Here are the responses that I received from people on the L - thanks to all that responded.
One: 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. Two: We rolled it out to all non-physician staff first (RNs, Respiratory, Unit Secretaries, etc) so they could answer physician questions. We then rolled out to physicians a few at a time. We have been live 2.5 years and we still put the POM Order Sheets in the paper chart as the Order History is not as easy to read. For an admission it is typical that the docs put in 20 meds. We have an admission order set with the standard meds and then other order sets that sometimes cover other meds. The physicians also save favorites. It has been awhile since go-live so I don't remember all of the pain. Make sure you have staff available to answer questions initially. We had a couple of pharmacists who learned CPOE at the expert level so they would sit with the physicians the first few times. We trained one-on-one with the physicians anywhere from 15 min to 1 hour depending on the comfort level. For the most part, they had all been using the EMR prior to go lab as that was the only way to look up labs so that helped considerably. We still don't require the consultants who are only here every few months to use CPOE. Three: 1. Yes, we implemented CPOE with a pilot group. Our pilot team consisted of 1 unit. Approximately 12 physicians and 12 nurses are LIVE with CPOE for this pilot. They began using it on 9/19/06. We have not rolled it out to any other units yet. 2. The only doctors who write written orders are the consulting physicians. The staff is aware of this, as are the consulting docs. Medical Records runs reports (1 standard, 1 custom) to figure out if any consulting doctors wrote orders for the discharged patient. Then they are located in the chart and closed appropriately. 3. Medication orders are copied from the interagency form. We will also be using the restorable orders feature in the very near future. All NF drugs require a request form to be completed. We have set up the NF request as a procedure in POM. The docs type in NF and are asked a series of questions such as, what is the drug that you need? Dosage? Why is this necessary? Etc. This order then prints in the pharmacy where they deem whether or not the drug is necessary or whether or not it can be replaced with a formulary item. 4. One big thing that we forgot about was all the physicians' orders for the nursing staff. We are still in the process of building these today. Four: We are 5.5 sr2 Magic. We went live with CPOE in July, we went with one doc first then added more. Not all docs are live yet. We did pilot everything except meds first using OE with our ward clerks and other lower level users to fix bugs and procedural issues, this was a hugely helpful choice. I wish we had done meds as well. The mix of electronic and paper orders we just deal with. We do have all the POM orders print out on the floors and then they fax us a copy to make sure we don't ignore orders sitting in the unverified queue. This helps nursing as well as pharmacy. I learned a lot of lessons during implementation and building! Thanks again to all that responded! Cindy Grolla, RN Clinical Project Leader Phone: 507.646.1209 Pager: 507.645.1475 -----Original Message----- From: Kowalczyk, Susan [mailto:[EMAIL PROTECTED] Sent: Tuesday, November 21, 2006 7:07 AM To: Grolla, Cindy; MediTech Users Group Subject: RE: [MEDITECH-L] CPOE Questions Please post responses. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Grolla, Cindy Sent: Sunday, November 19, 2006 4:42 PM To: MediTech Users Group Subject: [MEDITECH-L] CPOE Questions 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 ====================================== All messages should be posted in plain text. HTML will be converted to attachments. The meditech-l web site is MTUsers.com ______________________________________ meditech-l mailing list [email protected] http://mtusers.com/mailman/listinfo/meditech-l NOTE: This e-mail message may contain information that is privileged, confidential and exempt from disclosure. It is intended for use only by the person to whom it is addressed. If you have received this message in error, please do not forward or use this information in any way. Delete it immediately, and contact the sender as soon as possible by the reply option or by telephone at the telephone number listed (if available). Thank you. ====================================== All messages should be posted in plain text. 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