{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T07:51:21Z","timestamp":1660895481350},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>With the adoption of Computerized Patient Order Entry (CPOE), many physicians \u2013 particularly consultants and those who are affiliated with multiple hospital systems \u2013 are faced with the challenge of learning to navigate and commit to memory the details of multiple EHRs and CPOE software modules. These physicians may resist CPOE adoption, and their refusal to use CPOE presents a risk to patient safety when paper and electronic orders co-exist, as paper orders generated in an electronic ordering environment can be missed or acted upon after delay, are frequently illegible, and bypass the Clinical Decision Support (CDS) that is part of the evidence-based value of CPOE.<\/jats:p><jats:p>We defined a category of CPOE Low Frequency Users (LFUs) \u2013 physicians issuing a total of less than 10 orders per month \u2013 and found that 50.4% of all physicians issuing orders in 3 urban\/suburban hospitals were LFUs and actively issuing orders across all shifts and days of the week. Data are presented for 2013 on the number of LFUs by month, day of week, shift and facility, over 2.3 million orders issued.<\/jats:p><jats:p>A menu of 6 options to assist LFUs in the use of CPOE, from which hospital leaders could select, was instituted so that paper orders could be increasingly eliminated. The options, along with their cost implications, are described, as is the initial option selected by hospital leaders. In practice, however, a mixed pattern involving several LFU support options emerged. We review data on how the option mix selected may have impacted CPOE adoption and physician use rates at the facilities. The challenge of engaging LFU physicians in CPOE adoption may be common in moderately sized hospitals, and these options can be deployed by other systems in advancing CPOE pervasiveness of use and the eventual elimination of paper orders.<\/jats:p>","DOI":"10.4338\/aci-2015-05-soa-0065","type":"journal-article","created":{"date-parts":[[2016,1,20]],"date-time":"2016-01-20T07:11:11Z","timestamp":1453273871000},"page":"33-42","source":"Crossref","is-referenced-by-count":3,"title":["Toward the Elimination of Paper Orders"],"prefix":"10.4338","volume":"07","author":[{"given":"Ricardo","family":"Ramirez","sequence":"first","affiliation":[]},{"given":"S.","family":"Webster","sequence":"first","affiliation":[]},{"given":"George","family":"Gellert","sequence":"additional","affiliation":[]}],"member":"194","published-online":{"date-parts":[[2017,12,16]]},"reference":[{"key":"10.4338\/ACI-2015-05-SOA-0065-1","doi-asserted-by":"publisher","DOI":"10.1097\/HMR.0b013e3181c8b1e5"},{"key":"10.4338\/ACI-2015-05-SOA-0065-2","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2010-000043"},{"key":"10.4338\/ACI-2015-05-SOA-0065-3","doi-asserted-by":"crossref","unstructured":"McCullough JS, Casey M, Moscovice I, Prasad S. 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Washington, DC: National Academy Press, 1999"},{"key":"10.4338\/ACI-2015-05-SOA-0065-12","unstructured":"Institute of Medicine. Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press 2001"},{"key":"10.4338\/ACI-2015-05-SOA-0065-13","unstructured":"McGreevey M. Joint Commission Resources, Inc. Using Technology to Improve Medication Safety. 2005"},{"key":"10.4338\/ACI-2015-05-SOA-0065-14","unstructured":"http:\/\/www.leapfroggroup.org\/media\/file\/FactSheet_CPOE2.pdf. Assessed October 13, 2015"},{"key":"10.4338\/ACI-2015-05-SOA-0065-15","doi-asserted-by":"crossref","unstructured":"Friedberg MF, Chen PG, Van Busum KR, et al., Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy. 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