Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2003 Mar-Apr;10(2):188-200.
doi: 10.1197/jamia.m770.

A cross-site qualitative study of physician order entry

Joan S Ash  1 , Paul N Gorman, Mary Lavelle, Thomas H Payne, Thomas A Massaro, Gerri L Frantz, Jason A Lyman
Affiliations
Comparative Study

A cross-site qualitative study of physician order entry

Joan S Ash et al. J Am Med Inform Assoc. 2003 Mar-Apr.

Abstract

Objective: To describe the perceptions of diverse professionals involved in computerized physician order entry (POE) at sites where POE has been successfully implemented and to identify differences between teaching and nonteaching hospitals.

Design: A multidisciplinary team used observation, focus groups, and interviews with clinical, administrative, and information technology staff to gather data at three sites. Field notes and transcripts were coded using an inductive approach to identify patterns and themes in the data.

Measurements: Patterns and themes concerning perceptions of POE were identified.

Results: Four high-level themes were identified: (1) organizational issues such as collaboration, pride, culture, power, politics, and control; (2) clinical and professional issues involving adaptation to local practices, preferences, and policies; (3) technical/implementation issues, including usability, time, training and support; and (4) issues related to the organization of information and knowledge, such as system rigidity and integration. Relevant differences between teaching and nonteaching hospitals include extent of collaboration, staff longevity, and organizational missions.

Conclusion: An organizational culture characterized by collaboration and trust and an ongoing process that includes active clinician engagement in adaptation of the technology were important elements in successful implementation of physician order entry at the institutions that we studied.

PubMed Disclaimer

Comment in

References

    1. Kohn LT, Corrigan JM, Donaldson MS, for the Institute of Medicine Committee on Quality of Health Care in America. To Err is Human: Building a Safer Health System. Washington, DC, National Academy Press, 2000. - PubMed
    1. Ash JS, Gorman PN, Hersh WR. Physician order entry in U.S. hospitals. Proc AMIA Annu Fall Symp 1998:235–239. - PMC - PubMed
    1. Massaro TA. Introducing physician order entry at a major academic medical center. I: Impact on organizational culture and behavior. Acad Med 1993;68:20–25. - PubMed
    1. Massaro TA. Introducing physician order entry at a major academic medical center. II: Impact on medical education. Acad Med 1993;68:25–30. - PubMed
    1. Ash JS, Gorman PN, Hersh WR, Poulsen SP. Perceptions of house officers who use physician order entry. Proc AMIA Annu Fall Symp 1999: 471–475. - PMC - PubMed

Publication types