Computerized order entry: preventing spoiled doctors? | Edwin Leap

Edwin Leap:

I don’t understand why it’s so much better for me to enter orders than for the secretary, or even nurse in some instances, to enter them. Other people still vastly outnumber doctors in most departments. Further, I still work in two places where I check the box on the form, or tell the nurse/secretary, and they enter it into the computer.

Why was that so bad? Were there that many errors? Were the secretaries that overworked? Is the use of language, as in ‘Mr. Schwartz in room 5 needs CT angio to rule out PE,’ so utterly fraught with confusion and uncertainty? […]

And in an age of nurse empowerment, are nurses so unworthy of our confidence that they can’t do anything until it’s in the computer? I swear, I expect to someday say ‘start CPR’ and be asked, ‘did you put it in the computer yet?’

The answer to the question is not to allow more verbal orders, but to make the process of CPOE quicker and more convenient for physicians, namely by making it mobile and context-sensitive. It would be great working the ER, walk into a patient’s room, assess them, and then pull out my smartphone which would automatically pull up the particular patient (based on the fact that I’m standing in their room) and a menu of relevant orders based on their chief complaint with easy search for any other orders.

There is no reason why physicians can’t enter their own orders; we just need to make it quicker and easier.