title: Effect of computerized prescriber order entry on pharmacy: experience of one health system.
abstract: OBJECTIVE
  Pharmacists' satisfaction with a computerized prescriber order-entry (CPOE) system and the impact of CPOE on pharmacy workflows and order verification were investigated.
  
  
  CONCLUSIONS
  A mixed-method study was conducted to evaluate the implementation of a CPOE system in three hospitals of a large Michigan-based health system and early user experience with the system. Surveys of pharmacists before (n = 54) and after (n = 42) CPOE implementation indicated that they held generally positive expectations about CPOE prior to and during system implementation and continued to hold positive views about CPOE after several months of system use. In interviews and focus group discussions, pharmacists reported a number of important CPOE benefits, but they also cited challenges related to CPOE provider alerts, uncertainty about medication timing, and the need to support providers by serving as informal CPOE system trainers. Direct observation of pharmacists before and after CPOE implementation indicated decreases in both the rate of order clarification events (from 0.89 to 0.35 per hour, p < 0.001) and the average time spent per hour clarifying orders (from 4.75 to 2.11 minutes, p = 0.008).
  
  
  CONCLUSIONS
  Several months after CPOE implementation, pharmacists indicated that several aspects of their workload had improved, including the process of medication order clarification, their ability to prioritize work, and their ability to move around within the hospital to respond to demand. However, pharmacists also noted that order ambiguity still existed and that the system needed to be optimized to gain efficiencies and increase clarity.
authors.affiliation: Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids. carmit.mcmullen@kpchr.org.
authors.forename: Carmit K
authors.initials: CK
authors.lastname: McMullen
authors.affiliation: Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids.
authors.forename: Tara A
authors.initials: TA
authors.lastname: Macey
authors.affiliation: Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids.
authors.forename: Jill
authors.initials: J
authors.lastname: Pope
authors.affiliation: Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids.
authors.forename: Brian
authors.initials: B
authors.lastname: Gugerty
authors.affiliation: Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids.
authors.forename: Marti
authors.initials: M
authors.lastname: Slot
authors.affiliation: Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids.
authors.forename: Peter
authors.initials: P
authors.lastname: Lundeen
authors.affiliation: Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids.
authors.forename: Joan
authors.initials: J
authors.lastname: Ash
authors.affiliation: Carmit K. McMullen, Ph.D., is Investigator, Kaiser Permanente Center for Health Research, Portland, OR. Tara A. Macey, Ph.D., is Assistant Professor, Oregon Health & Science University, Portland. Jill Pope, B.A., is Senior Technical Editor, Kaiser Permanente Center for Health Research. Brian Gugerty, D.N.S., RN, is Chief Executive Officer, GIC Informatics, Annapolis, MD. Marti Slot, Pharm.D., is Clinical Pharmacy Specialist, Informatics; and Peter Lundeen, M.D., is Physician Solutions Architect, Technology and Information Solutions, Spectrum Health, Grand Rapids, MI. Joan Ash, Ph.D., is Professor, Oregon Health & Science University. Neil Carlson, Ph.D., is Director, Center for Social Research, Calvin College, Grand Rapids.
authors.forename: Neil
authors.initials: N
authors.lastname: Carlson
mesh_terms: D016303:Clinical Pharmacy Information Systems / Q000639:trends; D018672:Community Health Planning / Q000379:methods / Q000639:trends*; D003625:Data Collection / Q000379:methods / Q000639:trends; D006801:Humans; D050316:Medical Order Entry Systems / Q000639:trends*; D008510:Medication Systems, Hospital / Q000639:trends*; D008824:Michigan; D010595:Pharmacists / Q000639:trends*; D010604:Pharmacy / Q000379:methods / Q000639:trends*