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Determine Required Software

General

Hospital Information Systems (HIS) are complex systems which manage information and workflow in a hospital or health system setting.   HIS systems include the integration of data from clinical, financial, ancillary and administrative applications/modules such as:

• Clinical Data Repository  - consolidated clinical patient data view
• Laboratory Systems - laboratory department workflow, pathology, appointment scheduling, reports, billing
• Nursing Systems - patient charting, nursing notes and care plans, CDS, CPOE
• Pharmacy Systems- pharmacy department workflow, drug allergies, drug interactions, Bed-side Medication Administration model, pharmacy robotic systems, drug dispensing units, CDS, CPOE
• Physician Systems - review, documentation, ordering, CDS, CPOE
• Radiology & Imaging Systems - radiology department workflow, appointment scheduling, reports, billing, PACs

The selection of a Hospital Information System will normally occur years before a health system implements a CPOE module.    As hospitals review the CPOE module they will want to be sure the system is certified, patient and medical staff centric, affordable, scalable, flexible and secure.   Hospitals which develop in-house CPOE systems will be required to obtain a site certification from an Authorized Certifying Testing Body (ACTB) to be eligible for CMS incentive funds.  

Considerations in planning for budget expenses and resources for CPOE:

Do you need to upgrade your current HIS system to install the CPOE module?

Is your HIS vendor’s EHR or CPOE module on the federal Certified Health IT Product List?

Are there any software implementations dependencies?
Are there any additional or replacement of PCs, networking, other mobile devices (laptops, smart phones, etc) required?
What are the interface cost to other systems? 
What are Annual Maintenance costs?

What are vendor and health system Training costs?
Will you need additional vendor and clinical IT support staff for implementation and ongoing support as CPOE requires 24x7 coverage?

Is the software developed on standard development platform allowing providers to enter order remotely?

Does the CPOE system have a robust reporting feature?

Does the CPOE system integrate or include a CDS system to ensure patient safety?  

Resources: 

HIMSS has developed RFP templates along with contracting guidance to assist healthcare organizations in the software selection process.   The Clinical RFP includes a template for CPOE and order management systems.  Additional selection guidance is available in Getting Started with an EMR, Selecting an EMR for Your Practice: Evaluating Usability and EHR Selection Checklist.

HIMSS has also developed a comprehensive searchable database for HIT products and services.

KLAS has assembled accurate, honest and impartial performance ratings for hundreds of healthcare technology products and services.

How to implement CPOE successfully at your Hospital by John Halamka, MD

General Principles for Purchase and Safe Use of Computerized Prescriber Order Entry Systems from the American American Society of Healthcare-Systems Pharmasists Center on Patient Safety