CPOE effect on pharmacist workload

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konkan

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My hospital is gonna start CPOE next year. Has anybody gone through this process before? How your work is different now than it was before CPOE? What effect is it going to have on pharmacist jobs? I assume pharmacists will shift from order entry to order verification. Does that mean the hospital will need fewer Rphs?
 
My hospital is gonna start CPOE next year. Has anybody gone through this process before? How your work is different now than it was before CPOE? What effect is it going to have on pharmacist jobs? I assume pharmacists will shift from order entry to order verification. Does that mean the hospital will need fewer Rphs?

i don't think hospitals will need less Rphs. But they are needed not only to verify but to make sure that order was written correctly and there is no adverse events between different medications the patients are on.
 
what happens when every CPOE is wrong because providers aren't too skilled in it? then you're just doing double the work... Unless they have very very poor handwriting, I don't think it's that big of a deal.
 
I do not know of a facility cutting back on pharmacist hours post CPOE. The practice model for CPOE is to allow more pharmacist interventions instead of data entry while controlling the formulary and protocols instead of prescribers free writing for whatever they want.
 
I do not know of a facility cutting back on pharmacist hours post CPOE. The practice model for CPOE is to allow more pharmacist interventions instead of data entry while controlling the formulary and protocols instead of prescribers free writing for whatever they want.

Good point. It also helps with accreditation and CMS monies. But all that garbage that CPOE reduces errors, I hardly buy that... I think it depends on the institution and that the ones commissioning those studies are probably those with a monetary interest in CPOE software. Not all CPOE systems are user-friendly, and with some, it's hard to 'idiot-proof' them enough for providers...
 
I don't know of a perfect CPOE system...every system has a downfall. Tho, it should help reduce some errors. I like to think it's still in its infancy.
 
We are switching to Cerner this month. I had to go to a training the other day. From what the pharmacists tell me, CPOE makes things a lot more efficient. We are using IDX and things are built in a certain way so docs can only select certain products/dosages. All the notes, allergies, and other meds are in there for the pharmacists to review. Most of the time, the residents/docs put notes "pharmacy to dose" so the pharmacists do all the vanco and zosyn dosing/timing and stuff like that. They do all the TPNs and kinetics on the patients that need it. It has reduced our paperwork by a million times. We only get faxes to request missing doses/refills and faxes for orders from our outpatient specialty services and radiology and other areas like that. Even the ED uses CPOE making the time between order and getting the drug really short. I was there right before we switched to CPOE and we have hired 5 new pharmacists since then. Now we are going live on cerner soon. I'll let you know how it goes haha
 
not a pharmacist, but i've witnessed the process going from data entry to completely integrated CPOE. when i first started CPOE was in place, but our pharmacy dispensing system was not integrated with it, so we were still doing manual data entry, just with orders that weren't handwritten. A year or two later POE was interfaced with pharmacy system, thus theoretically creating less work.

However, (for my hospital's system) even though POE orders directly go to the pharmacy system and some info directly populates into the fields, the pharmacist still has to pick the correct dosage form and quantity and other things. While MDs can be idiots and will always freetext stupid orders, even pharamcists will pick totally ******* dosage forms that require splitting a capsule/patch/etc. It's still way safer compared to directly entering orders off paper, nowadays most issues with order entry errors are just wrong quantity or form, but correct drug.

In terms of jobs, data entry techs got moved to other areas, and they actually increased the number of pharmacists; every RPHs has to cover floors and process orders now, as opposed to the 4 RPhs in the basement who's sole job was to enter, so the individual workload was sorta increased. Initially it sucked because while everyone theoretically would rotate thru data entry, a lot of people were clueless when they were entering orders on the floor instead of the dedicated order entry people in the basement.

i don't think hospitals will need less Rphs. But they are needed not only to verify but to make sure that order was written correctly and there is no adverse events between different medications the patients are on.

Until people start getting used to all the automatic warnings like "your patient will go into rhabdo with simvastatin and xxxx drug" and automatically override with stuff like "will monitor as needed"
 
We have CPOE and have not cut down on staffing at all. In fact, there are more pharmacists now than there were a few years ago in my department. There is plenty of other types of work to do rather than order entry (thank God, that's not what I went to school for anyway).
 
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