A tale of two hospitals: a sociotechnical appraisal of the introduction of computerized physician order entry in two Dutch hospitals

Abstract

We compared the implementation of computerized physician order entry (CPOE) in two Dutch hospitals, one being an academic medical center and the other a large regional non-academic hospital. Both implemented the TDS7000 system that was running on the same computer, located in the computing department of the academic medical center. The outcomes of the implementation were different. The introduction of CPOE in the university medical center failed, while it was a success in the non-academic hospital. An appraisal of the different outcomes is possible when we consider the implementation of information as a thorough social process in which the technical and the social are closely interrelated. Our findings suggest that organizational change associated with CPOE implementation should not focus on individual physician behavior but on medical work as a collaborative professional effort