Commentary: Project Must Be Physician Led
[This article was originally published in Healthcare Quarterly, 10(sp) 2006]
Many of the lessons learned and advice regarding the implementation of CPOE at UHN are eerily similar to the experience at UPMC (University of Pittsburgh Medical Center) St. Margaret Memorial Hospital. St. Margaret successfully launched a CPOE project in September 2004, achieving 100% compliance with physician order entry within one month. The only place where paper orders exist is where computer order entry is cumbersome or not well supported by the software, such as dialysis and chemotherapeutic regimens.
Similar to UHN, we believe our key to success was having the project be physician led. In no way was CPOE ever promoted as an information technology project. It was always a physician-led quality initiative. One of the key strategies in this regard was the appointment of a chief medical informatics officer. The CMIO was responsible for assembling a Physician Advisory Committee as well as recruiting and assigning tasks to other physician leaders.
A second key component in the physician engagement strategy was that all training was physician led. One physician was assigned to oversee training. This physician helped to develop all training materials and recruit and teach other "super user" physicians to lead all training. In every training session, there was a super user present to answer questions and help frame things in a context that physicians would understand.
This diversified physician leadership worked hand in hand with administration as well as with the CMO and all other physician leadership to promote CPOE as a physician-led quality initiative and was the main key to success at St. Margaret Hospital.
About the Author(s)
Bill Fera, MD, is the Medical Director of the Wellness Center and Quality Liaison at St. Margaret Hospital (Pittsburgh, PA). He also serves on the Quality Patient Care Board and Quality Improvement Committee at University of Pittsburgh Medical Centre.
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