The value of CPOE in ambulatory settings.

The U.S. healthcare system faces enormous cost and quality challenges, and information technology is an essential tool that can address these challenges. One particularly critical area is computerized provider order entry (CPOE), considered to be the best technology for enabling providers to apply clinical evidence at the point of care. Accordingly, a groundswell of research, policy support, and business pressure is working to increase adoption of this technology in our hospitals. At the same time, the majority of care is now delivered in ambulatory clinical settings, where practices are typically owned by physicians. Yet physicians generally have been wary of adopting clinical systems due to concerns about return on investment, impact on clinical workflow, and the stability of vendors. To evaluate the efficacy of ambulatory computerized provider order entry (ACPOE), we need a clear understanding of its value proposition – the clinical, financial, and organizational return on investment – for practices of various sizes. Only then will we know whether providers should invest in clinical systems that provide outpatient order entry and whether vendors should invest in developing them. With this goal, we at the Center for Information Technology Leadership (CITL) undertook research to determine the value of ACPOE. What we found validates assumptions about quality improvement and challenges myths about financial benefits for providers.