Viewpoint: Controversies Surrounding Use of Order Sets for Clinical Decision Support in Computerized Provider Order Entry
- Affiliations of the authors: Department of Quality and Operations, Northwestern Memorial Hospital (AMB), Chicago, IL; Department of Information Technology Services, UW Medicine, University of Washington (THP), Seattle, WA; Departments of Internal Medicine, Hackensack University Medical Center (PAG), Hackensack, NJ; UMDNJ-New Jersey Medical School (PAG), Newark, NJ
- Correspondence and reprints: Anne M Bobb, BS Pharm, 676 North St. Clair Street, Suite 700, Chicago, IL 60611; Tel: (312) 926-9176; Fax: (312) 926-8734; e-mail: <abobb{at}nmh.org>
- Received 20 June 2006
- Accepted 16 October 2006
Abstract
Order sets provide straightforward clinical decision support within computerized provider order entry systems. They make “the right thing” easier to do because they are much faster than writing single orders; they deliver real-time, evidence-based prompts; they are easy to update; and they support coverage of multiple patient problems through linkages among order sets. This viewpoint paper discusses controversies surrounding use of order sets—advantages and pitfalls, decision-making criteria, and organizational considerations, including suggestions for vendors. Order sets have the potential to improve clinician efficiency, provide real-time guidance, facilitate compliance with Joint Commission on Accreditation of Healthcare Organizations and Centers for Medicare & Medicaid Services performance measure sets, and encourage overall acceptance of computerized provider order entry, but may not do so unless these controversies are addressed.
