What is Meaningful Use?
Meaningful use defines the use of Electronic Health Records (EHR) and related technology within a healthcare organization. Achieving meaningful use also helps determine whether an organization will receive payments from the federal government under either the Medicare or Medicaid EHR Incentive Program.
Organizations that are eligible for the Medicare EHR Incentive Program and achieve meaningful use by 2014 will be eligible for incentive payments; those who have failed to achieve that standard by 2015 may be penalized. To receive the maximum reimbursement, physicians and hospitals must achieve stage 1 of meaningful use of EHR for at least a 90-day period within the 2011 or 2012 federal fiscal year and for the entire year thereafter.
Those eligible for the Medicaid program must demonstrate meaningful use by 2016 in order to receive incentive payments.
What is CPOE?
Computerized Physician/Provider Order Entry (CPOE) is the act of a provider (physician, physician assistant, nurse practitioner, etc.) electronically entering patient orders instead of handwriting them on the paper Physician Order Sheet. Provider Order Management (POM) is the Meditech Application where patient orders are entered electronically. CPOE is a requirement for meeting stage 1 of meaningful use.
What is POM?
Provider Order Management is the Meditech application used for CPOE. Currently Order Entry (OE) is used to enter patient orders. OE uses categories, mnemonics or abbreviations to enter patient order(s). The questions attached to the orders are geared toward nursing and clinicians not providers. POM takes the listings of OE orders and allows the user to search for orders by using a type-ahead description search. OE looks to the order mnemonic while POM looks to the description of the order, thus allowing the user to search any word in the description. In addition to an easier search routine, the questions attached to the orders are geared toward the provider instead of nursing.
Who will be required to use CPOE and POM
All patient orders will be entered in POM by registered nurses, registered dieticians, respiratory therapists, speech and language pathologists, physician assistants, nurse practitioners, physicians, etc. Anyone that currently enters orders on a patient - and doing so is within their scope of practice - will be using POM for CPOE.
What are the benefits of CPOE?
- Easy to read orders with patient specific details
- NEW evidence based order sets
- Instantaneous allergy & drug interaction checking
- Pharmacy verification of med orders prior to routing to the eMAR
- NEW electronic nursing orders with links to the Intervention List
- Orders immediately available for Nurse Review from PCS Worklist
- Time from medication order to medication administration is decreased
- Improved efficiency of ordering process: physician enters order, primary nurse acknowledges order and carries out the order
When will the CPOE rollout begin at Hanover Hospital?
In mid April, the staff and hospitalists will begin training for POM/CPOE.
In late May, the organization will begin using POM and the Hospitalist group will start using POM for CPOE.
- Nursing will begin using POM for entering the orders as they “take the orders off” the paper Physician Order Sheet. They will also start “acking” the orders at that time.
- Hospitalists will begin entering electronic orders and using order sets.
- Non-hospitalist admitting physicians will begin using paper versions of the electronic order sets.
- Once the system is working well, it will be rolled out in waves to other physician groups.
How will charts with electronic orders be differentiated from those with hand written orders?
Charts with electronically placed orders will be flagged as a “hybrid” chart. Please note that a patient can have a mixture of both electronic and hand written orders. Consults and specialists can be involved in a patient’s care and writing orders while the hospitalists are entering electronic orders.
This “hybrid” chart will be in existence until all physicians are using CPOE.
How will I know when a new order has been placed?
Once the doctor electronically enters and signs the orders, a flag will immediately show on the user’s PCS Status Board under the “Order” header. This flag can show as a “STAT” for STAT orders, or “ACK” for anything but a STAT order.
At the top of the screen there is a listing of the orders. As each one is highlighted, the detail specific to that order will show below in the detail screen for reference/further instruction.
How will I know the difference between an order entered by a physician or provider and one entered by someone else?
The order source will be “Physician” for a physician-entered order. All others will have a source of any of the following: telephone, verbal, per protocol, per order, etc.
Where can Providers enter electronic orders from?
Providers can enter orders or view records from any computer within the Hanover Hospital Network and can access Meditech through a remote application, allowing orders to be entered from home and other places outside the hospital network.
When will physicians, nursing and other staff be trained?
Nursing and other clinical staff that enter orders in OE will be training in POM and PCS in the month of April.
Physicians in the pilot group will be trained 2-4 weeks prior to their group go-live with CPOE. This will be evaluated as the roll out moved progresses.
What kind of support will be in the hospital for CPOE?
There will be “Super Users” on each floor as well as 24-hour support during the first few weeks of the pilot physician group rollout. The effectiveness of this will be evaluated and revised as needed to ensure the success of each implementation.
Who can I ask CPOE questions of or offer feedback to regarding CPOE?
We have a dedicated email to answer your questions and concerns as well as gather your feedback. If a question is asked frequently, we will post it here within the FAQs.
Our email is:
cpoe@hanoverhospital.org.