development of a computerized physician order entry (cpoe) system group 22
DESCRIPTION
Development of a Computerized Physician Order Entry (CPOE) System Group 22. Mark Rafalko Michael Landau Wallace Title. PharmaSys, Inc. Full-service life sciences consulting firm in Cary, NC Founded in 1998 Specialize in validation and compliance for FDA regulated industries e MEDS - PowerPoint PPT PresentationTRANSCRIPT
Development of a Computerized Physician Order Entry (CPOE) System
Group 22
Mark RafalkoMichael Landau
Wallace Title
Full-service life sciences consulting firm in Cary, NC Founded in 1998 Specialize in validation and compliance for FDA regulated
industries
eMEDS
Development of medical informatics software for hospitals and care organizations Currently developing informatics technologies in Pungo District
Hospital in Belhaven, NC
PharmaSys, Inc.
Patrick Harris Patrick has a liberal arts background in business and math Head of eMEDS program
David Roth David has a masters in BME from Vanderbilt Currently lead software developer
Project Advisors
Problem Statement
Problem Statistics 44,000-98,000 people died due to medical errors in 19991
7,000 deaths were attributed to prescription errors in 20002
~5% of the 3 billion prescriptions filled annually are incorrect
Drug error rate before 2000 was around 10-20%3
Prescription Error Human errors during prescription ordering
1. Drug-drug conflicts2. Drug-food conflicts3. Drug-allergy conflicts
Other types of error1. Missing or incorrect information2. Wrong or incorrect dose3. Illegibly written prescription4. Non-formulary
Collects patient information from ADT Order and validate prescriptions with the CPOE Orders are filled by the PMS
PMS (Pharmacy, Management, System)
CPOE
ADT (Admissions, Discharge, Transfer
system)
CPOE Function
1. Hospital workflow flowcharts
2. Competitor research1. Interviews
2. Online seminars
3. Product requirements1. Joint application sessions with project advisors
4. Use-cases1. Functionality requirements
5. Prototype1. Prescription Ordering Page
2. Prescription Validation Page
3. Personal Calendar
Deliverables
Current Products CPOE systems being used in ~5% of hospitals nationwide WizOrder - Vanderbilt Hospital4
0.02% error rate recorded at Vanderbilt in 2002 ~4 million doses given annually at Vanderbilt Hospital
Current System Drawbacks Not intuitive
Require > 3 months of training System-wide replacements Don’t conform to user’s preferences
Project Assessment
Project Assessment
Verification Features (Drug Ordering Page)
1. Identity of patient
2. Dosage
3. Frequency
4. Patient conflicts• Allergies• Food• Other Medications
Title 11 Applies to electronic signatures
The user (physician) logging in with his ID and password will count as his electronic signature
Other FDA regulations do not currently apply to the CPOE system
FDA Approval
Project Goals
1) Develop a web-based CPOE system that is an improvement upon currently existing systems in terms of capabilities and pragmatism
2) Significantly decrease number of medical errors during prescription ordering
3) Make the application intuitive and user-friendly to significantly decrease training period
Solution
Hospital Workflow Analysis Design efficient application Account for all documentation Contacts at Vanderbilt Hospital
Personal and Customizable Preferred selections Personal schedule/workflow
Efficient Error Checking Program-server interaction
Application Speed Embedded features make performing tasks quick and simple Just as fast as writing a script
Completed Work
eMEDS Our software builds on this current HTML based system
Workflow analysis
Research current systems Analyze potential rooms for improvement
Use Cases Outline functionality and flow of application pages
Current Work
Static Prototype Use cases describe prototype functionality Not yet linked to the eMEDS software as a whole Design Layout Current pages under construction Calendar
Daily, Weekly, Monthly Prescription Ordering Prescription Validation Event Logging
Prototype: Drug Ordering
Prototype: Drug Validation
Future Work
Finish Static Prototype Set the appearance and functionality of the system
Finish calendar function
Testing Does the application satisfy design requirements? Physician prototype testing
Taking Prototype Dynamic Integrating page functions Connecting to eMEDS software
Potential Future Work
Make the CPOE prototype PDA compatible Link each user’s personal CPOE systems to collaborate
with each other’s decisions Link the user’s CPOE systems with the pharmacy Keep track of medication delivery from pharmacy Availability to sort medication times more pragmatically
References
1. To Err is Human: Building a Safer Health System. Institute of Medicine, John Lindo. Janet M. Corrigan, and Mella Donaldson, eds, National Academy Press, (1999).
2. “Prescription Errors Rising.” http://www.consumeraffairs.com/news/pharmacy_errors.html. Visited Feb. 16, 2008.
3. Kenneth Elie Bizovi, Brandon Beckley, Michelle McDade, Annette Adams, Andrew Zechnich and Jerris Hedges. The Effect of Computer-assisted
Prescription Writing on Emergency Department Prescription Errors. Academic Emergency Medicine Volume 8, Number 5 499, 2001.
4. Snyder, Bill. VUMC Honored for Reducing Medical Errors. The Reporter. Vanderbilt University Medical Center: December 20, 2002.