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McKesson

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McKesson/InSight Event

9/14 - 9/17
Denver, CO

McKesson Practice Newsletter
Volume 3 Issue 1, Page 1

Creating Cohesion between McKesson® CPOE and other Paragon™ Applications
By Lauri Gilliam

The implementation of the Paragon™ Computerized Physician Order Entry (CPOE) application represents a decision to fundamentally change the way care is delivered; affecting everyone in the organization from administrators, to clinicians, to patients. The purpose of CPOE is to improve care decisions, patient outcomes, patient safety, and efficiency.

The CPOE application provides caregivers (physicians, physician assistants, or nurse practitioners) who practice within Paragon facilities the ability to place orders on their patients for both inpatient and outpatient procedures. While the ordering personnel is usually referred to as a physician, other caregivers can also order tests. This product does not limit this functionality to physicians, but allows any caregiver with ordering privileges in the caregiver reference master and security to enter orders. The CPOE application is accessible from the Paragon WebStation for physicians and the order entry process is quick and easy.

Currently caregivers must write their orders on the patient’s chart or an outpatient order sheet. Those orders must then be transcribed by the unit clerk, nurse, ancillary department, or pharmacist and then be entered into the Paragon order entry system. Those orders are then transmitted electronically to the ancillary departments via requisitions. This process may result in transcription errors and/or delay the receipt of those orders to the providing department. These delays are especially problematic with Stat (urgent) orders. CPOE will reduce that order process time and streamline the order workflow.

With the installment of CPOE, physicians have access to all the information stored within Paragon on any given patient at any given time. They can use that information to increase patient care and safety. They have the ability to enter, hold, discontinue, cancel, change (edit), or reorder existing orders easily, regardless of the type of order. They also have the ability to view results, transcriptions, and all other patient information that can assist them in making the best decision on the care of their patient.

For those caregivers that are ready to adopt a CPOE type practice they are not typically willing to accept mixed electronic and manual documentation. It’s confusing to enter one type of order manually while entering others electronically. Paragon’s CPOE allows for entry of both ancillary and pharmacy orders, and as stated before, inpatient and outpatient orders. These features will assist in the buy-in from physician leadership and staff.

Caregivers that are not ready to adopt a new process want and must have a system that is intuitive and mimics their current order entry as closely as possible. Because of the mimicking aspect of order entry, the system will allow certain parameters of an order to be omitted. Additional information is required for many orders that need to be entered; however, Paragon CPOE will transmit incomplete orders to a work queue within the given ancillary department for final review and addition of required data. The same is true for orders going from CPOE to Paragon Pharmacy; the incomplete and complete order will show in the pharmacy work queue for review by the pharmacist.

Once the caregiver has submitted the orders their involvement at this point should cease (similar to paper order submission), until the order is reviewed by the ancillary department. At that point, if more information is needed by the caregiver in order to complete patient care, then the order is sent back to the caregivers work queue for further additions. For that to happen, integration between CPOE and other applications should be seamless. Below are examples that create cohesion amongst Paragon CPOE and other Paragon applications.

Examples of the integration with Paragon CPOE:
  • Paragon Order Management
    • Real-time update of orders into order inquiry (New, Discontinued, Hold, etc.)
  • Paragon Therapeutic Results Reporting, Paragon Radiology and Paragon Laboratory
    • Completed orders can be viewed and processed in all of these applications
  • Paragon Resource Scheduling
    • Completed orders that need to be scheduled will be sent to the Resource Scheduling work queue. Once the procedure is scheduled, the order will be updated and appear in Order Inquiry with the scheduled date and time
  • Paragon Pharmacy
    • Completed orders shall be sent to Pharmacy and populate the pharmacist’s work queue
    • When the order is reviewed and processed, Pharmacy will send an order update CPOE
  • Paragon WebStation for Physicians
    • The caregiver able to launch the CPOE application from the WebStation for Physicians
  • Interfaces with third-party ancillary Laboratory and Radiology systems
    • Paragon CPOE can be interfaced with third-party Laboratory and Radiology systems
    • Completed orders can be sent via HL7 messages to these systems, as occurs today

The ongoing benefits and success of a CPOE system are many and vary from one organization to another. To realize the benefits communication, training and coaching are essential for building understanding of CPOE, there must be a consensus throughout the hospital that acquisition of CPOE is not only important, but also the right thing to do.

For more information about implementing and integrating your CPOE application give us a call at 610.444.1233 or email us at vcs@getvitalized.com. You can find more information about VCS’ and our services and solutions by visiting our website www.getvitalized.com.