Promise of improved workflows and reduced medical errors to boost adoption of computerised physician order entry systems

Motivated by the need to achieve cost-effective and high-quality care, the European healthcare industry is increasingly turning to computerised physician order entry (CPOE) systems.

To maximise uptake among provider organisations and end users, vendors are expected to demonstrate their ability to smoothly manage the implementation process.

The CPOE systems are, today, one of the pillars of the clinical decision support (CDS) systems portfolio. Their proven ability to reduce occurrences of medical errors and improve clinical processes, pathways and workflows has been key to their growing popularity. Adoption levels are being boosted by the demonstrated ability of CPOE systems to deliver better healthcare quality even while controlling spiralling costs.

"Cost savings include those achieved by reduction in ordering of duplicate investigations and pharmacy prescriptions, unnecessary prescribing of high-value drugs and reduced hospital stay due to the control of treatment complications," explains Frost & Sullivan Healthcare Industry Analyst Siddharth Saha. "CPOE, by providing crucial, relevant and timely information, aids in the clinical decision-making process, thus shortening the patient's treatment plan and stay."

The increasing technological capabilities of CPOE systems are spurring interest among potential end users. For a healthcare industry used to the routine transactions of a hospital information system, the CPOE systems' interactivity is a major selling point.

At the same time, the growing use of mobile and wireless devices is also promoting interest in CPOE systems. The successful deployment of tablet PCs and personal digital assistants (PDAs) that complement the software system is stimulating CPOE system adoption by tech-savvy healthcare professionals.

Buoyed by these trends, the total European CPOE market is projected to grow at an annual average of 28.6 per cent over the 2003 to 2010 period to reach $137.0 million.

"The current low size of the overall market is because only a handful of enterprise CPOE implementations have been carried out, the rest being several basic order entry systems as part of clinical information systems," says Mr. Saha.

"Once this nascent market matures, and a stable clinical information systems platform is in place to accept high-end CPOE systems, the market is expected to really take off."

Due to increased implementation of integrated CPOE projects, the in-patient CPOE systems segment (which currently accounts for about 70.0 per cent of overall CPOE sales) is expected to dominate the industry over the long term. As the market shifts towards in-patient enterprise CPOE systems, the ambulatory care segment, which currently generates approximately 30.0 per cent of CPOE revenues, is set to lag behind.

The immediate challenge that both systems vendors and hospital management confront is of realising the true value healthcare IT solutions such as CPOE systems can deliver. Other areas of concern include managing technological challenges during adoption and implementation of systems and quality of existing baseline clinical information systems.

With CPOE implementation being one of the most complex integration activities among healthcare information technology initiatives, a key area where vendors will focus maximum attention, is the successful management of this costly, large-scale, complex, and change-inducing process.

"Hospitals can increase the likelihood of success by understanding and addressing gaps in CPOE readiness," remarks Mr. Saha. "Clinical decision support capabilities require additional efforts by the customers themselves. The organisation has the primary responsibility of developing the content and preparing the pathways and order sets for automation."

"This requires a process and structure for reviewing and approving content prior to automation and clear assignment of responsibility and accountability for each aspect. Ownership of the clinical content by the medical staff is critical," he adds.

In the next two years, the two largest country markets - Germany and France -- are likely to experience a small but encouraging enterprise CPOE penetration level of five per cent. Government-sponsored initiatives to modernise the healthcare information technology infrastructure are also likely to boost adoption rates in the United Kingdom. Scandinavia is also likely to witness the completion of several CPOE systems implementation contracts due to the high adoption of technology solutions.

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