BEVERLY, MA – There are several secrets to the Northeast Health System’s 96 percent uptake of computer physician order entry (CPOE), but they all boil down to collaboration.
“We really pulled together,” said Robert Laramie, CIO of the Beverly, Mass.-based health system, which serves communities along the state’s north shore. “It was amazing.”
The health system, which uses a Meditech electronic health record, includes 58-bed Addison Gilbert Hospital in Gloucester, BayRidge Hospital, a 62-bed psychiatric hospital in Lynn, and 227-bed Beverly Hospital in Beverly. There are also two outpatient facilities – Beverly Hospital at Danvers, a day medical and surgery center, and Beverly Hospital Cable Center in Ipswich.
All told, between 700 and 800 clinicians use CPOE.
Laramie and Jeffrey B. Newton, MD, a pulmonary physician and the lead champion of the CPOE project at Northeast, say the organization’s uptake is noteworthy in part because it shows that even small community systems can be ahead of the curve.
A Leapfrog Group survey released last April showed that only 7 percent of hospitals across the country have adopted CPOE. Leah Binder, CEO of the healthcare watchdog group, called the number “disappointing and disturbing.”
“CPOE is challenging and it takes time,” said David Bates, MD, chief of internal medicine at Brigham and Women’s Hospital in Boston, when the survey was released.
CPOE is also a critical component for proving meaningful use of information technology under the federal HITECH Act, which offers hospitals monetary incentives for meaningful use.
For Northeast, it was all about meaningful use from the start.
“It’s about commitment to patient safety,” Laramie said. “The biggest challenge was getting everyone on board and making them believe it would happen.”
Part of Northeast’s successful rollout had to do with preparation and a phased approach. Preparation entailed workflow analysis and the development of appropriate order sets.
When the time came for rollout, the CPOE team started with the easiest site and moved to the most complicated – from BayRidge to Addison Gilbert and on to Beverly. The system-wide rollout that began in January 2005 was completed last October.
A common goal and a commitment to 24/7 support for at least two weeks proved essential, officials said.
To help ensure success, users were provided with support. Several nurses were trained as “super users” and made available as the first point of contact whenever users ran into a problem.
“We wanted to make sure the frustration level would not build up at all,” Laramie said.
The attention given the workflow and the immediate support for those who ran into snags resulted in a boost in user confidence, Laramie said, as did the leadership Newton and other physicians provided.
“They had someone who could speak to them in their own language,” Newton said, “who knows what the issues are, the day-to-day problems.”
