The Lab’s Role in Facilitating Computerized Physician Order Entry

Computerized physician order entry (CPOE) systems are an excellent opportunity to coordinate interdepartmental, hospital-wide patient care efforts. CPOE is a technology-driven solution that suggests best practices in disease diagnosis and patient care, all the way from intake to discharge and through follow up.

For the clinical lab, “order sets” that spell out specific tests for specific patient groups or disease states are the cornerstone of CPOE efforts. When evidence-based medicine is used to develop the order set, there is great potential for quality improvement, reduction of medical errors, reduction of clinical variability, and even improved patient and physician satisfaction. Order sets should be not only evidence based, but also contain optional therapies and/or alternative therapeutic pathways.

Unfortunately, some care givers consider order sets “cookbook medicine” that limit care options. Laboratory professionals have a responsibility to educate their colleagues that the intention of order sets is not to replace clinical judgment and/or clinical expertise, but to enhance them. It should be emphasized that a physician always has the right to add or delete orders.

It is critical that all of the stakeholders actively participate in the development of order sets. Physicians, nurses, pharmacists, and IT analysts should not be the only participants. Laboratorians, radiologists, nutritionists and any other hospital personnel who impact patient care must be involved in this process. Many clinical decisions are influenced by laboratory results, so it’s vital for laboratorians to be involved in order set creation. The lab’s main goal should be the correct utilization of laboratory tests for diagnosis, monitoring, and/or prognosis of patient disease, with an eye to serving as a clinical consultant for treating physicians.