Brian Yeaman MD, Director Physician Informatics

1
CPOE Build and Design

• Brian Yeaman MD, Director Physician Informatics
• Norman Regional Health System

2
Ground Work

• Launched MEDITECH February 1, 2008
• CPOE committee started summer 2007

3
The Mountain

• 360 order sets physician specific and core
  measures
• Four Committees to pass one order set change
• Three programs and editing on paper and word
  documents
• File cabinets

4
First Major Steps

• CPOE committee is multidisciplinary
• Unit clerk, pharmacy, I.T., nursing managers,
  eight doctors, and administration (VPMA)
• Members in, and outside of, management
• CPOE committee can fast track order sets to the
  Medical Executives Committee for one-step
  approval
• Discrepancies go back to departments
• Minor edits and updates can happen exclusively in
  CPOE committee

5
Order Set Management

• Zynx- Author space and view space
• Migrate to MEDITECH for CPOE
• Migrate to a print style version stored in an
  electronic file cabinet for printing/paper use
  during transition
• New paper versions allows adjustment from bullet
  structure versus previous sentence structure

6
Order Set Coordinator

• The lynch pin
• Zynx, POM, AOM, PHA, OE expert
• Controls all changes in Zynx Author Space based
  upon Zynx View Space suggestions

7
Order Set Style Guide

• Future consideration
• Modular order sets that allow rapid changes to
  meet requirements of PI and core measures (Such
  as DVT prophylaxis, GI prophylaxis, vent bundle,
  etc.)
• Focus on measurement and outcomes during the
  build process

8
Timeline
9
Where We Are

• CPOE in the ED for and discharge meds
• Admission orders and full CPOE spring 2009
  starting in the ED
• Wait for BV and eMAR before CPOE inpatient
• Will have the majority of our order sets built
  and CPOE ready for the inpatient units
• Will launch CPOE on one unit and gradually expand
  the number of physician users
• Decision point unit-by-unit roll out vs. big
  bang (dependent upon nursing readiness, new
  campus and physician acceptance).