CPOE is not about implementing technology. It is about aligning our organizational culture with our healthcare delivery. It is also about our physicians acceptance and adopting the new paradigm. CIO The purpose in developing any strategy is to ensure that there is a strong and clear relationship between the investment decisions and the overall goals of an organization. For example, if an organization is interested in improving patient safety, then the strategy needs to be focused on CPOE. CPOE is by far one of the most extensive process re-engineering projects attempted by healthcare organizations. This project changes how medicine is practiced, and this change requires an understanding of the hospital culture, a strong project manager, and a well-thoughtout change management plan. The main goal is to obtain the acceptance of physicians. The justification for CPOE includes the strategic direction of the organization. The CIO and his team began to understand the organizational culture by way of conversations and interviews with physicians. These interviews, training sessions, and conversations built confidence and encouraged participation from the physicians. One method used by the CIO and his team was to hold one-on-one meetings with many of the physician leaders of the organization. These communications established the first stages of the CPOE project. The critical success factors of CPOE that were identified by the leadership team were: Usability by the physicians; Successfully decrease medical errors and/or poor clinical decisions due to medical conflicts; Decrease paper charting; and Information flowing from medical devices to the correct patient chart automatically. A project charter was developed, and the team gathered requirements to develop the project scope. Bob Smith, an experienced and proven project manager, was selected based on prior project management experience. The requirements for the CPOE project including infrastructure, hardware, software, conversions, interfaces, and reports were identified. MHSB uses the EMRCo system, the software from EMRCo Corporation, to automate clinician documentation, pharmacy and laboratory operations, medication administration processes, and bedside care activities. The hardware requirements for CPOE included a test server for the EMRCo system and a production server. A Bedside Medical Device Integration (BDMI) is required for point-of-care medication administration for 95 beds with a EMRCo Device Manager. The EMR system will have the ability to communicate between many medical devices such as ventilators, fetal monitors, and the patient record system. Clinicians will be able to verify the information and easily upload it directly into the patients EMR. This method has improved nursing efficiency, allowing nurses to spend more time at the patients bedside. Connecting devices to the EMR also has improved patient safety by reducing the likelihood of data-transcription errors. An anesthesiology module for post-anesthesia care unit as well as physical, occupational, and speech therapy (PT, OT, and ST) devices are also required. A few extra servers are also needed for storage of documentation. As far as infrastructure is concerned, production data storage and electrical and network wiring are also required. BMDI software, anesthesiology module, Operating System licenses, Lynx software, EMRCos maternity and nursing products, and voice dictation software are required to be integrated. A requirement to make sure that all reports continue to run in production was requested. Other requirements are conversions of stored historical tests, interfaces for anesthesiology module, BDMI, and other necessary software. The project scope was developed using the above-mentioned requirements. The CIO said, While continuing to build on our Clinical Documentation, we will be adding several applications during this two-year project. We will be starting with an upgrade of our current applications. We will then be adding and improving the capability for medical device information to flow directly into bedside medical device interfaces, and a way to more easily pull data into existing clinical views. Next, we will include the monitoring and charting of the Child Birth Unit (Maternity solution) along with connecting our anesthesiologists and their monitoring/charting with the anesthesiology module of the EMRCo system. Finally, we will be moving the Medical Records to a more robust documentation storage system (Medical Records Solution). In the final project stage, we will be setting up a system so all physicians can enter their own orders using CPOE. In addition, more documentation will be added in the Emergency Department.

What are the critical success factors of this project?