Computerized Physician Order Entry Goes Mobile

June 4, 2013
Marisa Torrieri

Thanks to technological advances, and perhaps encouraged by CMS’ EHR Incentive program requirements, CPOE is growing among healthcare organizations.

Thanks to technological advances, and perhaps encouraged by CMS’ EHR Incentive program requirements, Computerized Physician Order Entry (CPOE) is growing among healthcare organizations.

But as Practice Notes blogger and physician J. Scott Litton points out, while CPOE brings with it obvious advantages, it also has its disadvantages.

On the one hand, CPOE “removes the possibility of a ward clerk incorrectly deciphering a physician's illegible writing in order to enter orders for the inpatients,” he noted. On the other hand, it can be disruptive and is often seen by physicians as a way for hospital administrators to “encourage us to relinquish our privileges to the hospitalists for inpatient care,” Litton blogged.  

“When nurses page the physician to relay a patient concern or problems, our answer to the nurse can no longer be translated into an order,” Litton wrote. “Rather, we must stop what we are doing and go to a computer terminal and enter our orders directly for patient care. This work flow provides obstacles for patient care both in the office and in the hospital.”

Perhaps, then, it will be good news to some physicians that a new breed of CPOE applications for mobile devices that utilizes speech recognition technology could soon lessen those inconveniences.

In the fall, M*Modal, a provider of clinical documentation and speech-understanding technology, plans to roll out a speech-enabled CPOE product that can be accessed using iOS mobile devices, namely the iPad and iPhone.

The new software, which M*Modal co-developed with Intermountain Healthcare, will allow doctors to “conversationally order medication and other medical functions,” according to a press release.

M*Modal’s CPOE will support common, frequently prescribed medications based on a healthcare system’s formulary. In addition, the app will be designed to enable other order functions, including imaging (CT scans), nursing (catheters, checking vitals), and testing (lab tests, CBC, glucose). The app will fully support standards-based data exchanges as well as interoperate with Intermountain’s order-entry system.

M*Modal Jon Handler says it’s like “Siri for physicians.” Yet unlike other speech-recognition applications, such as the Siri voice recognition software, M*Modal’s cloud-based speech engine is customized for healthcare, he adds.

“Even in a fully implemented CPOE system, there are still some orders that are done as verbal orders. You get new information that requires you to take some action,” Handler told Physicians Practice. “If you don’t do the verbal order immediately, you are very likely to be interrupted and forget between now and the next time you are in front of a computer and have the opportunity to execute the order.”

Handler offered the example of the patient who is discovered to have pneumonia on a chest X-Ray. And the nurse wants to give the patient an antibiotic. The faster the antibiotic is given, the more likely the patient staves off pneumonia that flares out of control. 

But perhaps the biggest selling point of speech-enabled CPOE, says Handler, is the technology’s accuracy rate.

“We are working to build an app that helps you do it faster and more accurately,” said Handler. “Our goal is a combination of efficiency and reducing the errors that happen from verbal orders."

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