The healthcare information technologies have been adopted to improve the patient experience and achieve more efficient medical results. The implementation of such systems has become a major topic for debate in healthcare research and practice. The issues that prominently emerge include the usability of the systems and their interoperability. This paper summarizes a recent research article on the usability of computerizes provider order entry (CPOE). The article selected is a primary research article by Rabiei, Moghaddasi, and Heydari (2018). Using various other resources, the concept of interoperability of the CPOE will also be highlighted.
The CPOE is a critical part of the clinical information systems that allows the providers to order issues electronically. The study by Rabiei et al. (2018) seeks to explore the usability of the CPOE in electronic prescription in Tehran, Iran. The researchers used questionnaires in five hospitals that used the CPOE systems; a total of 50 questions were included in the questionnaires that were distributed to 254 nurses who used the system. IBM-SPSS was used for analyzing the data. The elements of usability examined included user friendliness, decision support, and prescription support. The concept of usability, as defined by Rizvi et al. (2017), entails a set of evaluation methods seeking to provide an understanding of the user experiences in healthcare technology. The ISO definition of usability is the degree to which a product is deployed with efficiency, effectiveness, and satisfaction to meet specified goals.
The evaluation of healthcare technologies also seeks to determine the interoperability of various healthcare information technologies. Interoperability entails the ability of two or more components of systems to share or exchange information and utilize it (Oyeyemi & Scott, 2018). The primary research by Rabiei et al. (2018) does not examine interoperability of the CPOE, but the findings indicate that interoperability is a serious issue. The review of literature presented by the authors indicate that the usability of the CPOE can be examined from its ability to display all orders, the capability of displaying all demographic and prescription data. In addition, the ability to generate alerts, control drug orders, and using multiple screens simultaneously can be also taken into account. Such elements of the CPOE are supported by the researchers, and they indirectly point to interoperability as the CPOE systems do not operate as stand-alone systems (Zahabi, Kaber, & Swangnetr, 2015).
The examination of the usability of CPOE reveals a number of issues. One of the most interesting findings was that the public hospitals were limited by the bureaucratic systems within which the acquisition and implementation of the CPOE were done. In private hospitals, however, the constraints were absent, and that allowed the private healthcare facilities to have a wider variety from which to select the CPOE systems (Rabiei, et al., 2018). Usability was, therefore, far better in private healthcare as compared to public hospitals. Another key finding that supports both usability and interoperability is the decision support. Rabiei et al (2018) found that decision support had the highest mean score which they interpreted as having the capability to interact with other sub-systems in the hospital information system. Such finding supports subsequent observations by such researchers as Elshayib and Pawola (2020) who find that the CPOE shows a high level of effectiveness when integrated or combined with the decision support systems of the hospitals. The clinical decision support systems can be seen as a major source of the data used in the CPOE.
The CPOE systems are implemented to improve patient experience, and the usability can be evaluated on the extent to which that objective is achieved. A summary of other key findings in the article by Rabiei et al. (2018) reveals how CPOE systems enhance the safety of the patients through error minimization among other processes. Patient safety was a key usability element with some CPOE systems examined achieving a mean score of 3.88. The patient safety attributes included the display of client medications when prescribing, mandating patients to explain the cause of subscription, requesting for signatures before subscribing, and enabling a subscription invalidation among others. Prescription support was another usability element that involved displaying of current and past prescriptions and the ability to add new drugs to the prescription. User-friendliness was assessed in terms of allowing users to return to previous screens and ease of use among other aspects. Lastly, the researchers examined usability in private hospitals where the score was higher than in public hospitals.
In conclusion, the research paper on the usability of the CPOE systems addressed the usability and interoperability concerns. The usability aspects examined in the research include patient safety, prescription support, and user-friendliness. Even though addressed as a usability aspect, decision support is seen as an interoperability feature that allows the CPOE systems to share data with other health IT systems and use it. The findings from the study conclude that the CPOE systems score high in terms of usability and interoperability. It has been established that the CPOE systems work best when used alongside the decision support systems.
References
Elshayib, M., & Pawola, L. (2020). Computerized provider order entry–related medication errors among hospitalized patients: An integrative review. Health Informatics Journal, 1-26.
Oyeyemi, A., & Scott, P. (2018). Interoperability in health and social care: Organizational issues are the biggest challenge. Journal of Innovation in Health Informatics, 25(3), 196-198.
Rabiei, R., Moghaddasi, H., & Heydari, M. (2018). Evaluation of computerized provider order entry systems: assessing the usability of systems for electronic prescription. Electronic Physician, 10(8), 7196-7204.
Rizvi, R., Marquard, J., Hultman, G., Adam, T., Harder, K., & Melton, G. (2017). Usability evaluation of electronic health record system around clinical notes usage – an ethnographyic study. Applied Clinical Informatics, 8(4), 1095-1105.
Zahabi, M., Kaber, D., & Swangnetr, M. (2015). Usability and safety in electronic medical records interface design: A review of recent literature and guideline formulation. Human Factors, 57(5), 805-834.