A first step towards meaningful use of EHR

CPOE will be necessary in any definition of meaningful use of EHR. But a recent survey by Leapfrog has concluded that only 7 percent of hospitals meet Leapfrog medication error prevention standards, which rely on CPOE. "According to our data," said Leah Binder, CEO of Leapfrog, a healthcare watchdog organization, "a majority of hospitals have significant safety and efficiency deficits."

Also the recent KLAS CPOE Digest 2009: Meaningful Use and Physician Adoption shows concern about the adoption rate. The report also suggests that the level of CPOE adoption could signify which vendor will have the best chance of stimulating physician EMR adoption and achieving meaningful use. "Though EMR technology has yet to be deployed at many community hospitals and most physician practices, the vast majority of hospitals with more than 200 beds have already chosen a strategy and a solution for electronic medical records," said Jason Hess, general manager of clinical research for KLAS and author of the new CPOE study. "For those larger facilities, the goal now becomes one of proving that their EMR solutions will actually be used by physicians, replacing paper-based orders and instructions with computerized physician order entry."

HIMSS has released definitions for meaningful use of certified electronic health records technology. They recommend in the first phase an EHR infrastructure that includes clinical data display and CPOE with "independent licensed practitioners" entering the order. "The vast majority of orders emanating from an ambulatory practice are medications, laboratory testing or consultative requests," according to the recommendations. "For electronic prescribing, CPOE must be operational within the EHR." Without CPOE it is doubtful that meaningful use will be determined ror an EHR.