Planning for Paragon CPOE
By Janice Macdonald

As hospitals are striving to comprehend ‘meaningful use’, one thing seems clear; CPOE will be a significant part of the plan. McKesson plans to release the Paragon CPOE module in the spring of this year, it may become generally available as early as April, 2010.

System features in the Paragon CPOE module include the following:

• Comprehensive order entry
• Fully specified medication orders: First DataBank OrderView
• Clinical decision support: First DataBank Clinical Screening modules
• Order entry authorization
• Complex order sets
• Electronic signing and co-signing workflow support
• Workflow oriented order entry: integration with WebStation for Physicians
• Closed loop medication management integration
• Physician adoption reporting
• Information resource linking

CPOE presents the opportunity to improve clinical outcomes through the practice of evidenced based medicine. Successful implementation, however, will require physician ownership of the process and buy in to the continued use and development of this tool.

Infrastructure updates may be required in preparation for CPOE. SQL Server 2005 Enterprise edition and Internet Explorer 7.0 are required. The First DataBank Enhanced Data Bundle with multiple applications license and the First DataBank OrderView license are required. Physician access to workstations, or other system access devices, will be a critical part of physician acceptance and adoption. The hospital CPOE implementation plan should include a review of physician workflow and peak usage times specific to order entry and budgeting for additional access devices.

Paragon Pharmacy Management is also required for CPOE, and the CPOE module will integrate with Paragon Order Management, Clinical Care Station, and WebStation for Physicians. Paragon CPOE will utilize the Order Management order descriptions and aliases, but will use a new CPOE Order Manager to complete and verify physician orders. In Clinical Care Station, a new bubble will notify nurses of new orders and the Order Inquiry function will reflect all orders for a patient.

Reviewing current policies and procedures is highly recommended in the early stages of a CPOE project. This process will help to identify the current state of clinical orders in the hospital and begin to frame the future state with Paragon CPOE. This process should also help to identify policy changes that will be required. Some questions to consider are:

• Will CPOE training be a requirement for credentialing?
• Will the Pharmacy and Therapeutics Committee make decisions relate to CPOE configuration, or another clinical committee?
• How can CPOE support our patient safety initiatives?
• How will medical staff decisions be implemented within CPOE?
• How will hospital policies and procedures be implemented in CPOE?
• How will verbal orders be handled?
• How will nurses verify CPOE orders?

These are just a few of the important questions to consider during the transition to CPOE. This project will touch almost every aspect of hospital operations. Putting together a dedicated clinical team with strong physician leadership to engage in collaboration and planning with the IT team is the best way to get your CPOE project on the road to success.

For more information on CPOE and VCS’ Readiness Assessment contact us at (610)444.1233 or vcs@getvitalized.com. For more information about VCS’ services and solutions visit our website at www.getvitalized.com.