Informatics Evaluation and Outcomes and Effectiveness Research
Computerized physician order entry
Computerized physician order entry denotes a process of entering medical instructions in a computerized and electronic format. This information gets relayed to end users who carry out the stipulated instructions. The physician in charge of hospitalized patients writes and transmits orders and instructions to the departments in charge of the patient. In turn, these departments carry out the orders as received. This procedure helps in the elimination of misunderstandings that may arise between the physician and the departments due to handwriting issues (Morris, Savelyich, Avery, Cantrill & Sheikh, 2005).
Prior to the use of the computerized physician order entry systems, physicians could write down instructions to departments that had to oversee a patient. This process gave huge margins of error arising, mainly, from handwriting issues. The ambiguity of instructions further added to the confusion (Leapfrog Group, 2004). All these issues promoted the mistrust of the handwriting system by patients and the affected families. This promoted a big challenge arising from the numerous departments involved.
The coordination between the physician and the line departments presented a cumbersome procedure, in that the same writing could go to each and every one of them. In case of loss of the scrip containing the instructions, the patient could start all over again. At the end of the exercise of medication, the instruction script could end up in tatters due to the many handlers involved.
With the advent of the electronic physician data entry, issues arising from handwriting were covered. There no longer arose misinterpretation or misinformation from physicians to the involved departments (Connolly, 2005). The problem of multiple handling the same script of instructions by many departments was solved, in that; the same instructions could now get electronically relayed to the involved departments.
The entry of computer literate physicians promoted the introduction, and subsequent use, of the computerized physician order entry. Further, according to Smith (2013), the economic benefits of the computerized system promoted the saving of over eighty billion dollars a year in the United States alone. This realization led to the setting of a target that about sixteen per cent of clinics in the United States could implement this method by 2006 (Leapfrog Group, 2004). The success of the implementation of the whole exercise depended on the restructuring of systems, creating conducive environments and dealing with physicians reluctant to change (Leapfrog Group, 2004).
The success of computerized physician order entry started at the United States at the department of Veterans Affairs (Leapfrog Group, 2004). The successful implementation of a computerized system that aided in the entry of patient information presented a break-through in research. The system could capture patient data like medications, lab tests, x-rays and time of medication by which department (Smith, 2013). This breakthrough presented an easy way of obtaining and keeping patient records. Further, the comments or intervention of the different departments involved could get accessed easily.
In the United Kingdom, the National Health Service, as of 2006, had a target of getting sixty million nationals on the computerized health record by 2010 (Morris et al, 2005). This process involved the gradual access to patient documents and getting them on board. The main source of the information lay in all health service providers. As documented at the community hospital at Massachusetts, over fifty five thousand people could get prevented from wrong or adverse medication when the computerized system could get implemented.
Discuss how you would perform a needs assessment for the project.
The first step of carrying out an assessment on the need of this technology would involve the carrying out of a survey pertaining to cases of patient care under manually written and communicated instructions as opposed to computerized systems. The survey could cover the financial impacts of handwritten instructions, their effectiveness, their subject to misinterpretation and being misunderstood. This survey could bring out the imbalances and negative effects of handwritten works (Smith, 2013).
- Discuss how you would formulate a research question
The research question would seek to cover the impact of the electronic system as opposed to the manual method of transmission of instructions from physicians to line departments (Smith, 2013). The answer to the research question would lead to the determination as to whether the electronic method or the manual and handwritten method serves the process of communication well. The research question would seek to explore the effects and impacts of the effective method, so as to give a conclusive reply. In order to create a research question, I would ensure that the question is in line with the topic (Leapfrog Group, 2004). I would take necessary measures to enable create a succinct research question that portrays relevance and that which is specific.
- Explain how you would develop a hypothesis.
The hypothesis statement would seek to bring out a clear understanding of the research question through agreeing or disagreeing with the question. Therefore, the hypothesis relies heavily on the research question in an effort to unravel required results. Depending on the framing of the research question, whether in an affirmative or negative manner, the answer obtained qualifies or disqualifies the hypothesis statement.
- Discuss the purpose of your research.
The purpose of my research would entail the study of the previous methods used in writing, keeping and communicating patient data as compared to the electronic method. The research would cover the research done on the communication of patient information in health systems, their advantages, shortcomings and disadvantages. The research would then cover the introduction of the electronic method, its benefits, challenges and shortcomings (Smith, 2013). The aim of the research would seek to promote computerized physician order entry.
- Discuss what research method would best fit the situation
The descriptive-qualitative research method best suits this case (John, 2010). The research would involve the giving of detailed descriptions, observations made, interviews conducted and feedback from documents reviewed. This method would present situations as they occur, how the program would get implemented, challenges faced and the perceptions of the different people involved in the study. This research method, further, would bring out any changes and impacts caused the outcomes of the implementation.
- Explain what you would measure and measurement method.
The main component that would involve measurement entails the determination of the number of people supporting the electronic method as opposed to the manual method of patient data transmission. This would bring out the will of the majority of people, considering that different people harbor different opinions in any matter. The higher the number of people supporting any one argument would definitely indicate the prevalence over the other option (Connolly, 2005). The measurement method would involve quantitative determination of participants supporting against those opposing one method of data sharing: either electronic or annual/handwritten.
- Explain the benefit of one data collection tool or technique you would use
I would prefer conducting interviews as a data collection tool (John, 2010). Interviews involve talking to participants in an effort to get their views on the topic at hand. They present a more informed approach since cases of collaboration among groups, as arises in questionnaires, gets eliminated. Interviews, further, give a chance to get first-hand information and knowledge from a primary source, thereby enhancing the trust in information collected. This technique ensures timely acquisition of research results.
- Discuss how you would analyze the data you gather
The analysis of the data collected would involve going through the data and pitting those supporting against those supporting the computerized method of physician order entry. The analysis would also seek to study the reasons given in support or against the method (John, 2010). The use of percentages, pie charts or graphs would, clearly, bring out the differences between the two camps (those supporting against those opposing). The analysis would also seek to bring out the more supported concept among a majority of the participants.
- Discuss how you would draw conclusions
The drawing of a conclusion would, mainly, depend on the analysis of the collected data. In instances where more participants favor computerized physician order entry, the research would get concluded that, given the reasons brought forth by a majority of participants, computerized order entry should get in use. On the other hand, if a majority of participants oppose electronic order entry, the handwritten method should continue.
Connolly, C. (2005). “Cedars-Sinai Doctors Cling to Pen and Paper”. The Washington Post. Retrieved on 25th Jan 2013. From http://www.washingtonpost.com/wp- dyn/articles/A52384- 2005Mar20.html
John, G. (2010). four Levels of Measurement in Social Science Research. retrieved on 25th Jan 2013 from http://johngarger.com/articles/methodology/4-levels-of-measurement-in- social-science-research
Morris, C. J., Savelyich, B. S. P., Avery, A. J., Cantrill, A., & Sheikh. A. (2005). “Patient safety features of clinical computer systems: questionnaire survey of GP views”. Quality and Safety in Health Care14 (3): 164–168. doi:10.1136/qshc.2004.011866. PMC 1744017. PMID 15933310. Retrieved 2006-07-08. http://qualitysafety.bmj.com/content/14/3/164.full
Smith, P. A. (2013). Making computerized provider order entry work. London: Springer.
The Leapfrog Group. (2004). “Hospital Quality & Safety Survey“. Retrieved on 25th Jan 2013 from http://www.leapfroggroup.org/media/file/Leapfrog-Survey_Release-11-16- 04.pdf
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