Objective

Due to the rapid advancement in information technology, changes to communication modalities are increasingly implemented in healthcare. One such modality is Computerised Provider Order Entry (CPOE) systems which replace paper, verbal or telephone orders with electronic booking of requests. We aimed to understand the uptake, and user acceptability, of CPOE in a large National Health Service hospital system.

Setting

Adult acute hospital in England

Design

Retrospective single centre study.

Participants

Between October 2008 and July 2019, a total of 8 035 132 orders were requested in PICS.

Outcome

Well-placed and specifically developed CPOEs are becoming an integral form of communication in acute hospitals such as our own. A large number of departments and specialities have adopted this technology, creating many opportunities for further development of the systems in place, increased audit/traceability, and subsequently, improved patient care.

In just over 10 years, UHB has progressed from entirely paper orders to nearly entirely electronic orders. Since this is a clinical-driven change, and involves clinician choice, we conclude that this has translated into clinicians using the system. Future work via time and motion studies could confirm if this improves efficiency and clarity, and if it consequently improves patient care.

Methods

Records of every request (imaging, specialty review, procedure, laboratory) made through Prescribing Information and Communications System (PICS) were collected between October 2008 and July 2019 and resulting counts were presented.

Results

In the first 6 months of implementation, a total of 832 new request types (imaging types and specialty referrals) were added to the system. Subsequently, an average of 6.6 new request types were added monthly. In total, 8 035 132 orders were requested through PICS. In three example request types (imaging, endoscopy and full blood count), increases in the proportion of requests being made via PICS were seen. User feedback at 6 months reported improved communications using the electronic system.

Conclusions

CPOE was popular, rapidly adopted and diversified across specialties encompassing wide-ranging requests.