Arieh Rosenbaum, MD, hospitalist at California Pacific Medical Center (CPMC) in San Francisco, has for years been involved in technology issues at his hospital, which is developing a new electronic medical record with CPOE. It will replace a 15-year-old, DOS-based CPOE system he describes as “powerful but clunky.” However, CPMC’s parent, Sutter Health, is rolling out the new computer system gradually across its 40 Northern California facilities. It won’t reach CPMC until 2011.
“It’s an incredibly complex project,” Dr. Rosenbaum says. “To Sutter’s credit, they’re trying very hard to get physicians’ input, establishing structures for gathering feedback at the corporate and local levels. I am one of the physicians who will be involved at the local level, both building the clinical content and interface as well as gaining physicians’ acceptance and participation.”
Success depends on how the new system relates to physicians’ workflow. “Everybody knows the benefits of CPOE, but there are mitigating factors, such as what to do when the system crashes,” he says. “Hospitalists are the people who will be interacting with the new system the most. It’s our job to be leaders and to be aware that this is in our future.”
Head-On Approach
Timothy Hartzog, MD, a pediatric hospitalist and medical director of information technology/CPOE at Medical College of South Carolina (MUSC), Charleston, urges hospitalists to take CPOE seriously and view it as an opportunity.
“Implementation of CPOE, or electronic medical records, can be one of the most fundamental changes a hospital makes—affecting the workflow of everybody who works there,” he says. “As physicians, we each work a little differently. With the standardization imposed by CPOE, it’s going to make some physicians a little crazy, no matter how well it’s implemented.”
Dr. Hartzog encourages hospitalists to set aside any doubts they may have and get involved in creating workable CPOE solutions.
“Hospitalists don’t have to be experts in technology,” he stresses. “If you learned medicine, you can learn the technology—if you’re willing to put in some time, read a couple of books, take some training, and work with your IT people. Tackle CPOE head on—make sure your voice is heard. Be part of the build. But you need to have time dedicated for the IT project, and you need to do the work. If you are not present and if other people on the development group don’t know you and hear you speak, decisions will be made when you’re not in the room.”
For some physicians, Dr. Hartzog says, it could even be fun. “Especially if we can actually make the system work for us. We can actually create something that makes life better for our group.” TH
Larry Beresford is a regular contributor to The Hospitalist.
References
- Campbell EM, Sittig, DF, Ash JS, et al. Types of unintended consequences related to computerized provider order entry. J Am Med Inform Assoc. 2006 Sept-Oct;13(5):547-556.
- Connolly C. Cedars-Sinai doctors cling to pen and paper. The Washington Post, March 21, 2005:A1.