title: Attitudes and perceptions of pediatric residents on transitioning to CPOE.
abstract: BACKGROUND
  Many resident physicians have experienced transitioning from traditional paper documentation and ordering to an electronic process during their training.
  
  
  OBJECTIVE
  We sought to investigate the attitudes and perceptions of residents related to implementation of computer provider order entry (CPOE) and clinical decision support (CDS).
  
  
  METHODS
  Pediatric residents completed web-based surveys prior to CPOE implementation and at 6 months and 12 months after implementation. The survey assessed resident attitudes and perceptions related to CPOE and the use of CDS tools. Additionally, at 6 and 12 months, residents were asked how electronic medical record (EMR) resources might impact future career decisions.
  
  
  RESULTS
  Prior to CPOE implementation, 70% of residents were looking forward to CPOE, but 28% did not want to transition from paper ordering. At 12 months post-implementation, 80% of residents favored CPOE over paper ordering and only 3.33% wished to revert to paper ordering. Residents reported an increase in time needed to enter admission orders 6-months after CPOE implementation. By 12 months post-implementation, there was no significant difference in perceived time to complete admission orders when compared to pre-CPOE responses. Most residents (91.67%) identified that overall EMR resources were an important factor when considering future employment opportunities. The most important factors included the degree of EMR implementation, technology resources and the amount of support staff. The least important factors included patient portal access and which EMR product is used.
  
  
  CONCLUSIONS
  Overall, residents demonstrated a preference for CPOE compared to traditional paper order entry. Many residents remained unaware of CDS tools embedded within CPOE at the 12 month follow-up, but a majority of residents did find them helpful and felt more knowledgeable about current guidelines. EMR resources, including degree of EMR implementation, technology resources and support staff are likely to be important factors as residents take future employment opportunities into consideration.
authors.affiliation: Indiana University School of Medicine , Department of Pediatrics.
authors.forename: A R
authors.initials: AR
authors.lastname: Shriner
authors.affiliation: Indiana University School of Medicine , Department of Pediatrics.
authors.forename: E C
authors.initials: EC
authors.lastname: Webber
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D007196:Indiana; D007396:Internship and Residency / Q000706:statistics & numerical data*; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D000078329:Workforce
keywords: Computer provider order entry; clinical decision support; electronic medical record