CPOE and CDSS
A CDSS (decision support alerts) Embedded in a CPOE (Prescribing Order Entry) for Intravenous HEPARIN
ORDER ENTRY
Weight, last heparin dose, and related laboratory tests displayed on the screenDirect by Test Doctor at 13th September 2016-1512
** Wt 94.0 kg (206 lbs) 25 Aug 2247
**Plt
** INR
**aPTT
**Hgb
**Hct
**Preg **Lact
**Hep IVP
**Med Alrg nkda 25 Aug 2247
HePARIN Drip New Order
Platelet Warning:
Low platelet count warningRECOMMENDATION: STOP HEPARIN AND SEND HEPARIN INDUCED THROMBOTCYTOPENIA ANTIBODIES (PLATELT FACTOR 4). Pt
Platelet count has dropped by more than 50% or is less than 100 10^9/L.
Wt Consideration:
Weight Alertrecommendation: RE-TAKE WT. Wt was taken over 72 hours ago.
Baseline Labs:
Missing baseline laboratory results warningRECOMMENDATION: Obtain baseline aPTT, Platelet Count and INR lab values prior to proceeding with order.
Rx & Lab Trend:
Suggested IV Dose:
Suggested weight-based dose1.395 Units/hr (wt (kg) * 15 Units/kg/hr)
Max Dose Alert:
RECOMMENDATION: MAX DOSE 1.000 UNITS/HR. MAX RATE 10 ML/HR.
The Rationale behind Your Design Development
CPOE- Computer Provider Order Entry, along with Clinical Decision Support can enhance the safety of medicine prescription (Kuperman, et al., 2007). The rationale for the development of the physician order entry with CDSS comprises of process enhancement, support for cost-based decisions, support also for clinical decisions, as well as optimization of physicians' timeframe. Also, CPOE with CDS systems is considered one of the best ways to enhance health care service and improved safety of the patients. When the electronic records of the patients become increasingly accessible, the systems will inevitably become the method that medical care staffs will choose. It is a complex process creating a CPOE/CDS system. Indeed, some of them fail even after consuming a lot of resources and time.
How to Implement the CPOE/CDS System
CPOE presents many advantages and disadvantages. If it is not implemented in stages, one is likely to experience the full extent of its pitfalls. It must start with viewing it in the laboratory. The next steps include addition of dictations, viewing of images, basic chart and eventually graduated to CPOE system on form. Even with such pre-implementation precautions, the system can still confuse physicians...
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