Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis
Introduction Relevant clinical information is vital to inform the analytical and interpretative phases of most investigations. The aim of this study is to evaluate the impact of implementation of computerised provider order entry (CPOE), featuring order-specific electronic order entry forms (eOEFs),...
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BMJ Publishing Group
2023-03-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/12/1/e002143.full |
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| author | Caroline Cullerton Daniel Weiand Robert Oxley Chris J Plummer |
| author_facet | Caroline Cullerton Daniel Weiand Robert Oxley Chris J Plummer |
| author_sort | Caroline Cullerton |
| collection | DOAJ |
| description | Introduction Relevant clinical information is vital to inform the analytical and interpretative phases of most investigations. The aim of this study is to evaluate the impact of implementation of computerised provider order entry (CPOE), featuring order-specific electronic order entry forms (eOEFs), on the quality and quantity of clinical information included with investigation requests.Methods The CPOE module of a commercially available electronic health record (Cerner Millennium) was implemented at a large, tertiary care centre. The laboratory information management system was interrogated to collect data on specimens sent for microbiological culture 1 year before implementation of CPOE (2018), immediately post implementation (2019) and 6 months post implementation (2020). An interrupted time series analysis was performed, using text mining, to evaluate the quality and quantity of free-text clinical information.Results In total, 39 919 specimens were collected from 16 458 patients. eOEFs were used to place 10 071 out of 13 735 orders in 2019 (73.3%), and 9155 out of 12 229 orders in 2020 (74.9%). No clinical details were included with 653 out of 39 919 specimens (1.6%), of which 22 (3.4%) were ordered using eOEFs. The median character count increased from 14 in 2018, to 41 in 2019, and 38 in 2020. An anti-infective agent was specified in 581 out of 13 955 requests (4.2%) in 2018; 5545 out of 13 735 requests (40.4%) in 2019; and 5215 out of 12 229 requests (42.6%) in 2020. Ciprofloxacin or piperacillin-tazobactam (Tazocin) were mentioned in the clinical details included with 421 out of 15 335 urine culture requests (2.7%), of which 406 (96.3%) were ordered using eOEFs. Subsequent detection of in vitro non-susceptibility led to a change in anti-infective therapy for five patients.Conclusions Implementation of CPOE, featuring order-specific eOEFs, significantly and sustainably improves the quality and quantity of clinical information included with investigation requests, resulting in changes to patient management that would not otherwise have occurred. |
| format | Article |
| id | doaj-art-a2da8640c0f744eca89d9c79c03e097b |
| institution | DOAJ |
| issn | 2399-6641 |
| language | English |
| publishDate | 2023-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-a2da8640c0f744eca89d9c79c03e097b2025-08-20T02:58:19ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-03-0112110.1136/bmjoq-2022-002143Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysisCaroline Cullerton0Daniel Weiand1Robert Oxley2Chris J Plummer3Medical Microbiology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UKMedical Microbiology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UKMedical Microbiology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UKCardiology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UKIntroduction Relevant clinical information is vital to inform the analytical and interpretative phases of most investigations. The aim of this study is to evaluate the impact of implementation of computerised provider order entry (CPOE), featuring order-specific electronic order entry forms (eOEFs), on the quality and quantity of clinical information included with investigation requests.Methods The CPOE module of a commercially available electronic health record (Cerner Millennium) was implemented at a large, tertiary care centre. The laboratory information management system was interrogated to collect data on specimens sent for microbiological culture 1 year before implementation of CPOE (2018), immediately post implementation (2019) and 6 months post implementation (2020). An interrupted time series analysis was performed, using text mining, to evaluate the quality and quantity of free-text clinical information.Results In total, 39 919 specimens were collected from 16 458 patients. eOEFs were used to place 10 071 out of 13 735 orders in 2019 (73.3%), and 9155 out of 12 229 orders in 2020 (74.9%). No clinical details were included with 653 out of 39 919 specimens (1.6%), of which 22 (3.4%) were ordered using eOEFs. The median character count increased from 14 in 2018, to 41 in 2019, and 38 in 2020. An anti-infective agent was specified in 581 out of 13 955 requests (4.2%) in 2018; 5545 out of 13 735 requests (40.4%) in 2019; and 5215 out of 12 229 requests (42.6%) in 2020. Ciprofloxacin or piperacillin-tazobactam (Tazocin) were mentioned in the clinical details included with 421 out of 15 335 urine culture requests (2.7%), of which 406 (96.3%) were ordered using eOEFs. Subsequent detection of in vitro non-susceptibility led to a change in anti-infective therapy for five patients.Conclusions Implementation of CPOE, featuring order-specific eOEFs, significantly and sustainably improves the quality and quantity of clinical information included with investigation requests, resulting in changes to patient management that would not otherwise have occurred.https://bmjopenquality.bmj.com/content/12/1/e002143.full |
| spellingShingle | Caroline Cullerton Daniel Weiand Robert Oxley Chris J Plummer Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis BMJ Open Quality |
| title | Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis |
| title_full | Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis |
| title_fullStr | Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis |
| title_full_unstemmed | Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis |
| title_short | Impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests: an interrupted time series analysis |
| title_sort | impact of computerised provider order entry on the quality and quantity of clinical information included with investigation requests an interrupted time series analysis |
| url | https://bmjopenquality.bmj.com/content/12/1/e002143.full |
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