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Step 5: Achieve Meaningful Use Stage 2

Computerized Physician Order Entry (CPOE) for Medication, Laboratory and Radiology Orders

Objective:

Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines

Measure:

More than 60% of medication, 30% of laboratory, and 30% of radiology orders created by the EP during the EHR reporting period are recorded using CPOE

Changes from Meaningful Use Stage 1:

 Stage 1Stage 2
Objective Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines
Measure More than 30% of unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE More than 60% of medication, 30% of laboratory, and 30% of radiology orders created by the EP during the EHR reporting period are recorded using CPOE

*Note: On August 23, 2012, CMS announced the Meaningful Use Stage 2 final rule which also impacted the Stage 1 CPOE measure. See the Stage 1 CPOE Changes as of August 2012 for more information.

Clinical Importance:

In using CPOE for medications, orders are incorporated with patient information, such as other prescriptions and lab results, which can be automatically checked for potential errors or problems. This real-time cross-check improves optimal drug selection and reduces errors at the time of ordering. This is a safer and more effective way to order medications than using prescription pads or paper forms. It reduces the chance of selecting medications for which the patient has a known allergy, or drugs that are off-formulary for their health plan. Additionally, the medication information is updated in the patient’s medical record and easily available for follow-up visits.

National Learning Consortium Resources:

The NLC resources are examples of tools that are used in the field today, and that are recommended by “boots-on-the-ground” professionals. The NLC, in partnership with HealthIT.gov, shares this collective EHR implementation knowledge and resources throughout this site. 

National Learning Consortium Resources
Resource NameDescriptionSource

Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems

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Study deriving a nationally representative estimate of medication error reduction in hospitals attributable to electronic prescribing through computerized provider order entry (CPOE) systems. JAMIA

Computerized Provider Order Entry Studies

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Summary of PubMed articles specific to computerized provider order entry (CPOE) implementation, case studies, and best practices.

AccessMedicine

The material in these guides and tools represents the collective EHR implementation experiences and knowledge gained directly from the field of ONC’s outreach programs (REC, Beacon, State HIE) and through the Health Information Technology Research Center (HITRC) Communities of Practice (CoPs) in their performance of technical support and EHR implementation assistance to primary care providers. The information contained in these resources is not intended to serve as legal advice nor should it substitute for legal counsel. The resource list is not exhaustive, and readers are encouraged to seek additional detailed technical guidance to supplement the information contained herein.

Reference in this web site to any specific resources, tools, products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.

 

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