Computerized Provider Order Entry at Emory Healthcare

Abstract

The Computerized Provider Order Entry at Emory Healthcare case presents one hospital system's efforts to implement computerized provider order entry (CPOE) across all of its hospitals and the challenges they faced in doing so. Issues such as standardization of care, how to handle medication reconciliation, and unexpected challenges (e.g., changes to the post-op ordering process, lack of a human gatekeeper to monitor order flow, increase in lab orders). Dr. Bill Bornstein, Chief Quality and Medical Officer of Emory Healthcare in Atlanta is responsible for the smooth implementation of CPOE at Emory Healthcare, which is a vital part of their $50 million electronic medical record initiative. By June 2009, CPOE had gone "live" at Emory University Orthopaedics and Spine Hospital, Emory University Hospital, and Wesley Woods Hospital in a staged rollout. While Dr. Bornstein felt good about how the implementation had gone thus far, as he looked ahead next month to July 13, 2009, the fast approaching go-live date for Emory University Hospital Midtown (EUHM), he was concerned about the challenges and possible perils that lay ahead. He considered what additional actions he should take to prepare for go-live at Midtown, and if Midtown was ready for CPOE at all. One thing was certain; this hospital was different. The Computerized Provider Order Entry at Emory Healthcare case presents one hospital system's efforts to grapple with the challenges of implementing CPOE and the reactions that result. Issues such as how to deal with a workforce that has mixed views about the value of implementing such systems, the pros and cons associated with standardization of care, as well as how to deal with unexpected changes to work processes are brought out in the case. The case also allows for discussion of how to plan a phased implementation with adequate time for organizational learning to occur between the time that various sites "go live."

Learning Objective: The Computerized Provider Order Entry at Emory Healthcare case presents one hospital system's efforts to grapple with the challenges of implementing CPOE and the reactions that result. Issues such as how to deal with reactions from a workforce that has mixed views about the value of implementing such systems, the benefits and costs associated with standardization of care, as well as how to deal with unexpected changes to work processes are brought out in the case. The case also allows for discussion of how to plan a phased implementation with adequate time for organizational learning to occur between the time that various sites "go live."