Computerized Physician Order Entry (CPOE) for Medication Orders
Use computerized physician order entry (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.
More than 30 percent of all unique patients with at least one medication in their medication list seen by the eligible professional have at least one medication order entered using CPOE.
Changes as of August 2012:
Beginning in 2013, CMS added an optional alternate measure to the objective for computerized provider order entry (CPOE). The original measure for CPOE was based on the number of unique patients with a medication in their medication list that was entered using CPOE. The new, alternate measure is based on the total number of medication orders created during the EHR reporting period. An EP, eligible hospital, or CAH may select either measure for this objective in Stage 1 in order to achieve meaningful use. (Note that this alternative measure will be required for all providers in Stage 2.)
Alternate Measure: More than 30 percent of medication orders created by the EP or authorized providers of the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23) during the EHR reporting period are recorded using CPOE.
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.
Lessons from the Field
"Never underestimate the value of shoulder to shoulder training to assist clinicians in becoming efficient in using their EHR and entering orders."
— Phil Deering, Regional Coordinator, Regional Extension Assistance Center for Health Information Technology (REACH)
Field service consultants have learned how important it is for a practice to identify and utilize "super users," providers or staff who are able to move through the EHR quickly and can share helpful hints, tips, and techniques. Super users can also provide additional shoulder-to-shoulder training to assist their co-workers and peers in becoming more efficient users of their EHR. Also, clearly demonstrating the connection between orders that are entered and how they are then used (e.g., to trigger alerts, bring up BPAs or order sets) can help providers understand why the initial challenge of entering the order is worthwhile and how it can positively impact care delivery, resulting in a higher degree of CPOE compliance.
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|
Computerized Provider Order Entry Studies
Summary of PubMed articles specific to computerized provider order entry (CPOE) implementation, case studies, and best practices.
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.
Related CMS EHR Incentive Program Frequently Asked Questions
- #3257 - How should an EP who orders medications infrequently calculate the measure for the CPOE objective if the EP sees patients whose medications are maintained in the medication list by the EP but were not ordered or prescribed by the EP?
- #2851 - Who can enter medication orders in order to meet the measure for the CPOE meaningful use objective? When must these medication orders be entered?
- #3057 - To meet the meaningful use objective for CPOE, should EPs include hospital-based observation patients whose records are maintained using the hospital's certified EHR system in the numerator and denominator calculation for this measure?
- #2771 - Is the physician the only person who can enter information in the EHR in order to qualify for the EHR Incentive Programs?
- #2813 - What do the numerators and denominators mean in measures that are required to demonstrate meaningful use?
- #2765 - For EPs who see patients in both inpatient and outpatient settings, and where certified EHR technology is available at each location, should these EPs base their denominators for meaningful use objectives on the number of unique patients in only the outpatient setting or on the total number of unique patients from both settings?
- #2883 - If an EP is unable to meet the measure of a meaningful use objective because it is outside of the scope of his or her practice, will the EP be excluded from meeting the measure of that objective?
- #3065 - Should patient encounters in an ambulatory surgical center be included in the denominator for calculating that at least 50 percent or more of an EP's patient encounters during the reporting period occurred at practices/locations equipped with certified EHR technology?
- #3077 - If an EP sees a patient in a setting that does not have certified EHR technology but enters all of the patient’s information into certified EHR technology at another practice location, can the patient be counted in the numerators and denominators of meaningful use measures?
For additional questions around meaningful use, visit the CMS EHR Incentive Program Frequently Asked Questions (FAQs).