HOW FAR ALONG ARE MASSACHUSETTS' HOSPITALS?
In April 2007, a brief on line survey was sent to sixty-one acute care hospitals that were known to have not fully implemented CPOE. Here are the survey results.

1. Describe the status of your Hospital CPOE Implementation

* Ten hospitals that have fully implemented
CPOE were not surveyed.

2. Specify the target date for beginning
the CPOE pilot

• The majority of hospitals said 2008, a few would
  start in 2007 and the remainder in 2009

3. How many units will be/are involved in the pilot?

• Almost 50% of the respondents had not yet determined

4. Do you plan to switch vendors for your CPOE application?

• The majority were staying with their current HIS vendor

5. When do you anticipate physicians will be
entering at least 75% of orders electronically?

• 24% 2008
• 38% 2009
• 12% 2010
• 10% 2011
• 16% Not Sure

6. Do you have a CPOE Leader?

• 62% said yes

7. Do you have a physician champion
assigned to CPOE?

• 57% said yes

8. Will your CPOE system have the following clinical decision support?

• Over 90% will have drug to drug and allergy checks
• 56%  will have renal dosing
• 55% will have a monitor for expensive drug utilization
• 40% were undecided about IV to Oral guidance
• 71% will monitor for redundant labs

IMPLEMENTATION SUPPORT SERVICES ON THE WAY
The Massachusetts Hospital CPOE Initiative, which began almost two years ago, has the goal of achieving full CPOE implementation in all hospitals by 2011. There are currently 71 acute care hospitals in Massachusetts. Of those, approximately, 50 hospitals have not yet begun their implementation and many have not even started to plan.

A majority of Massachusetts hospitals are still struggling with how to develop a successful model for CPOE. In many cases, these hospitals do not possess in-house professional expertise. Some do not have the funds necessary to procure services to assist in CPOE implementation. In June, the Initiative issued a Request for Proposal seeking qualified CPOE experts to create a pool of qualified consultants capable of assisting Massachusetts acute care hospitals and their medical staffs. Individuals/firms are currently being evaluated and those respondents selected will work closely with the Initiative to design and facilitate educational programming, lead special interest roundtable forums, assemble tool kits, and provide additional services based on an assigned scope of work. This format will permit the Initiative to leverage its funding and address the broader needs of hospitals while promoting collaboration among professionals responsible for CPOE.

All services provided will be vendor agnostic so that all hospitals can take advantage of the free learning opportunities that the Initiative will provide. Our focus is to encourage peer learning to reduce the time it takes to adopt CPOE.

Selected members of the CPOE Ad Hoc Committee volunteered to review and evaluate the RFP respondents. Selection of consultants will be made in early August so that programming can begin in early fall. The committee will continue to work with MTC/NEHI in the development of programming and topics to meet a variety of hospital needs.

CPOE PHYSICIAN ROUNDTABLE SCHEDULED
The first of a series of Physician Roundtables addressing the challenges of implementing CPOE will be held on September 19, 2007, 7:30-9:00 am at the Massachusetts Medical Society in Waltham. This forum is a follow-up to the January educational program, entitled Physician Involvement and Governance. In response to requests we are bringing physicians together in a series of peer to peer learning regarding physician leadership and moving technology forward as it specifically relates to CPOE.

Reid Coleman MD, Medical Information Officer at Lifespan will facilitate the session. Dr. Coleman has successfully guided the Lifespan system through CPOE readiness and implementation. Dr. Coleman will share his “lessons learned”. This forum is an excellent opportunity to meet colleagues and expand upon learning. Physician’s interested in attending should RSVP to mdroundtable@masstech.org

MTC/NEHI TO PUBLISH A SECOND VERSION
OF CPOE LESSONS LEARNED
MTC/NEHI has engaged the First Consulting Group to conduct national research on community hospitals that have successfully implemented CPOE. A combination of site visits and interviews are planned. The publication, due out in late Fall, will focus on operations as opposed to planning.  Some of  the topics, recommended by the CPOE AD Hoc Committee are: ongoing support, optimizing CPOE, models for ongoing management of order sets and other clinical decision support, and information flow/medication reconciliation.

If you have any questions, please contact:
Bethany Gilboard
Director, Health Technologies
Massachusetts Technology Collaborative
email: gilboard@masstech.org
phone: 617-371-3999 ext. 201

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