"We have built our system to immediately auto-page ancillary staff, immediately notifying EKG technicians, respiratory therapists, X-ray technicians, and phlebotomists," he said. Such a system cuts turnaround times and lowers the chance of error.
Conant and other industry experts also recommend identifying departmental and organizational provider champions -- high-level staffers or hospital executives -- to take part in the design, building, testing, training, implementation and maintenance involved in a CPOE project. These champions will need analyst and clerical support, and they should be compensated for their time, since they will be taken away from their clinical practices, Conant said.
The nonprofit Certification Commission for Health Information Technology (CCHIT) is currently the only organization accredited by the U.S. Department of Health and Human Services (HHS) to certify that EHR systems in use at private physician practices and larger healthcare facilities meet meaningful use criteria. The HHS's Office of the National Coordinator is currently working on new rules for accrediting other organizations to certify EHR systems.
"Until that happens, there can be no final certification of products that physicians and hospitals can rely on," said Sue Reber, marketing director at the CCHIT. "So it looks like it's being pushed pretty far back, and that creates a problem. If you're a physician and you've already rolled out EHR under a previously accredited vendor... then all you have to do is get the product updated with the vendor's newly accredited software [and if you] have fair amount of patient data to work with, you'll be in pretty good shape."
For hospitals, EHR certification is even more complicated. That's because hospitals don't rely on all-inclusive bundled systems like the ones that smaller practices purchase. At hospitals, technology is rolled out piecemeal and requires integration. Since many hospitals won't consider ripping and replacing existing IT infrastructures, they're forced to integrate new documentation systems, CPOE systems and relational databases with existing technology.
Most hospitals began using health information technology far earlier than smaller physician practices, but they purchased that technology department by department. A hospital, for instance, may have a patient admission system for its front office; a different patient transfer system for other departments; separate administration systems for the emergency room, the laboratory, the pharmacy and the radiology departments; and separate physician order entry systems. And all those systems may have come from different vendors.