Dataset Information

An assessment of Health Care Information and Management Systems Society and Leapfrog data on computerized provider order entry.

ABSTRACT:

Objective

To assess the internal consistency and agreement between the Health Care Information and Management Systems Society (HIMSS) and the Leapfrog computerized provider order entry (CPOE) data.

Data sources

Secondary hospital data collected by HIMSS Analytics, the Leapfrog Group, and the American Hospital Association from 2005 to 2007.

Study design

Dichotomous measures of full CPOE status were created for the HIMSS and Leapfrog datasets in each year. We assessed internal consistency by calculating the percent of full adopters in a given year that report full CPOE status in subsequent years. We assessed the level of agreement between the two datasets by calculating the κ statistic and McNemar's test. We examined responsiveness by assessing the change in full CPOE status rates, over time, reported by HIMSS and Leapfrog data, respectively.

Principal findings

Findings indicate minimal agreement between the two datasets regarding positive hospital CPOE status, but adequate agreement within a given dataset from year to year. Relative to each other, the HIMSS data tend to overestimate increases in full CPOE status over time, while the Leapfrog data may underestimate year over year increases in national CPOE status.

Conclusions

Both Leapfrog and HIMSS data have strengths and weaknesses. Those interested in studying outcomes associated with CPOE use or adoption should be aware of the strengths and limitations of the Leapfrog and HIMSS datasets. Future development of a standard definition of CPOE status in hospitals will allow for a more comprehensive validation of these data.

SUBMITTER: Diana ML

PROVIDER: S-EPMC3207193 | biostudies-literature | 2011 Oct

REPOSITORIES: biostudies-literature

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Publications

An assessment of Health Care Information and Management Systems Society and Leapfrog data on computerized provider order entry.

Diana Mark L ML Kazley Abby Swanson AS Menachemi Nir N

Health services research 20110330 5

<h4>Objective</h4>To assess the internal consistency and agreement between the Health Care Information and Management Systems Society (HIMSS) and the Leapfrog computerized provider order entry (CPOE) data.<h4>Data sources</h4>Secondary hospital data collected by HIMSS Analytics, the Leapfrog Group, and the American Hospital Association from 2005 to 2007.<h4>Study design</h4>Dichotomous measures of full CPOE status were created for the HIMSS and Leapfrog datasets in each year. We assessed interna ...[more]

PMID: 21449956

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Project description:BackgroundComputerized provider order entry (CPOE) systems have been introduced to reduce medication errors, increase safety, improve work-flow efficiency, and increase medical service quality at the moment of prescription. Making the impact of CPOE systems more observable may facilitate their adoption by users. We set out to examine factors associated with the adoption of a CPOE system for inter-organizational and intra-organizational care.MethodsThe diffusion of innovation theory was used to understand physicians' and nurses' attitudes and thoughts about implementation and use of the CPOE system. Two online survey questionnaires were distributed to all physicians and nurses using a CPOE system in county-wide healthcare organizations. The number of complete questionnaires analyzed was 134 from 200 nurses (67.0%) and 176 from 741 physicians (23.8%). Data were analyzed using descriptive-analytical statistical methods.ResultsMore nurses (56.7%) than physicians (31.3%) stated that the CPOE system introduction had worked well in their clinical setting (P < 0.001). Similarly, more physicians (73.9%) than nurses (50.7%) reported that they found the system not adapted to their specific professional practice (P = < 0.001). Also more physicians (25.0%) than nurses (13.4%) stated that they did want to return to the previous system (P = 0.041). We found that in particular the received relative advantages of the CPOE system were estimated to be significantly (P < 0.001) higher among nurses (39.6%) than physicians (16.5%). However, physicians' agreements with the compatibility of the CPOE and with its complexity were significantly higher than the nurses (P < 0.001).ConclusionsQualifications for CPOE adoption as defined by three attributes of diffusion of innovation theory were not satisfied in the study setting. CPOE systems are introduced as a response to the present limitations in paper-based systems. In consequence, user expectations are often high on their relative advantages as well as on a low level of complexity. Building CPOE systems therefore requires designs that can provide rather important additional advantages, e.g. by preventing prescription errors and ultimately improving patient safety and safety of clinical work. The decision-making process leading to the implementation and use of CPOE systems in healthcare therefore has to be improved. As any change in health service settings usually faces resistance, we emphasize that CPOE system designers and healthcare decision-makers should continually collect users' feedback about the systems, while not forgetting that it also is necessary to inform the users about the potential benefits involved.

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Dataset Information

An assessment of Health Care Information and Management Systems Society and Leapfrog data on computerized provider order entry.

Objective

Data sources

Study design

Principal findings

Conclusions

Publications

An assessment of Health Care Information and Management Systems Society and Leapfrog data on computerized provider order entry.

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