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Biopharma: Computerized Order Sets

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HIP Perspectives Biopharma Insights – February 2017

Computerized Order Sets Help Physicians Save Time and Improve Care

By Brian Bamberger,  Practice Lead, Life Science

All physicians want to save time and improve the quality and outcomes of care. Computerized order sets present such a solution to busy clinicians. Now that most practices and hospitals have transitioned to electronic health records (EHRs) and electronic prescribing (ePrescribing), physicians can issue prepackaged groups of orders for care processes and the diagnosis and treatment of a particular condition with a few clicks of a mouse.

Benefits.
There are many benefits in using computerized order sets. They can help reduce medical errors because physicians do not have to rely on their memory for treatments and help avoid transcription errors. Also, because they are based on evidence-based guidelines and standards of care issued by many specialty groups and other organizations, such as the National Cancer Care Network (NCCN) and American Society of Clinical Oncology, computerized order sets also promote adherence to those standards. Accessing order sets via EHRs allows physicians to easily incorporate evidenced-based care into their work flows. Research has shown that implementing electronic clinical order sets ultimately improves patient outcomes. Multiple studies have found reductions in overall lengths of hospital stay, postoperative lengths of stay and total costs for various surgical procedures, including total knee arthroplasty, appendectomy and colon surgery. Finally, there is evidence that suggests they influence ordering.

Why not paper order sets? To be sure, order sets have been around in paper form for a long time.  However, they are quickly becoming obsolete. The most compelling reason for this is that the health care world is rapidly going electronic, and with that comes advantages over paper. For example, a paper-based order set may not be available at the time a physician needs it. In contrast, having order sets available in the physician’s EHR means the information is rapidly available anytime. Electronic order sets may also be part of requirements to standardize health care across an organization. These can, for example, figure into shared savings arrangements for such new value-based programs as accountable care organizations. They can also help practices meet quality and payment targets based on use of health information technology for Medicare and other payers. Data from electronic clinical order set systems can be captured and made available for analysis. This can produce valuable insights regarding trends and patient care, which again can help improve outcomes and quality as well as reduce costs.

Challenges and opportunities. The transition to computerized order sets can be challenging for physicians. However, they create opportunities for pharmaceutical sales teams. For example:

  • Customization. Customization of electronic order sets creates value to physicians by saving time and being directly applicable to ways they practice medicine. Sales representatives can work with practice administrators to customize order sets to a particular disease state or medication therapy. For this, physicians and practices will need individualized help. Think of it as developing a personalized macro that is adapted to the needs of their practice and patient mix. Specialty organizations such as the NCCN have developed templates that can be easily customized. Many hospitals have order sets that are automatically triggered following a specific procedure (sometimes called standing orders). Naturally, customization will continue to be an evolving process as new disease states and treatments are identified. This creates valid and useful reasons for continuous physician interaction.
  • Physician buy-in. Buy-in is important if physicians are to use a customized order set. Ensuring these sets link to evidence-based therapies can help achieve that goal. Assisting physicians in customizing their order sets engages them in the process and creates buy-in.
  • Training is needed. Training and retraining are critical to the success of implementing computerized order sets. This may be difficult for small or rural practices. Assisting with training is a way to open doors to physician practices and provide value to the interaction. This also could create the opportunity for brand reinforcement.

Point-of-Care Partners is proficient in the use of EHRs and ePrescribing. Let us work with you to create a program for developing and customizing electronic order sets for your target practices. They are the wave of the future.