2012 CPOE and Meaningful Use Research Brief
A survey was conducted to identify how Single Sign-On helps with Electronic Medical Records (EMR) adoption, Computerized Physician Order Entry (CPOE) adoption and meeting Meaningful Use. The ARRA/HITECH legislation is causing Healthcare organizations to roll out technologies and change their processes with the goal of improving the quality of patient care and lowering costs. Care providers such as physicians and nurses are directly impacted requiring them to change how they deliver patient care. Since Meaningful Use of Electronic Medical Records is about adoption – care providers need to be on board and utilizing the technology put in place, otherwise hospitals will not meet Meaningful Use requirements, gain incentives and prevent Medicare reimbursement reduction come 2015. This online survey polled 211 IT decision makers and executives; the data received from the survey is analyzed in this research brief and their profiles are presented below in Tables 1-4.
Single Sign-On (SSO) Impact on EMR, CPOE Adoption and Meaningful Use
EMR and CPOE implementations are notorious for gaining very little usage, IT rolls the projects out and very few users, especially highly mobile busy clinical staff such as physicians, log in and actually use the systems. With most hospitals focused on meeting Meaningful Use requirements, it’s critical that physicians enter orders via CPOE and all staff utilize the EMR. But, in order to gain wide spread adoption, the technology barriers of repeatedly entering usernames and passwords must be removed. When asked if Single Sign-On helps with EMR and CPOE adoption, and meeting Meaningful Use, the majority of hospitals with a SSO solution (Figure 1) strongly agree/agree that it is a key factor.
And of those with no SSO solution (n=41) 68% indicate that SSO is something they want to do (Figure 2)—they recognize the value of how it will help their organization.
CPOE adoption has been a challenge for years and some say it is the most difficult requirement within Meaningful Use. Stage 1 Meaningful Use requires that 30% of med orders be entered via CPOE within a 90 day reporting period while Stage 2 is proposing to expand that to 60% and include laboratory and radiology orders within a 12 month reporting period. As Figure 3 shows, the number one blocker to CPOE adoption is resistant to workflow changes.
Due to the ongoing challenge of CPOE adoption, hospitals need to find creative ways to encourage physicians to enter orders electronically in order to meet the Stage 1, and the more stringent Stage 2, requirements. As shown in Figure 4 below 74% of hospitals indicated they are using SSO to increase CPOE adoption. Interestingly 48% also indicated they are using Virtual/Roaming Desktops, and 46% indicated that they are using Remote/Mobile access. The level of use in these areas correlates with the results of the Imprivata 4th Annual IT Trends Survey, conducted in early 2011, and is consistent with our survey carried out in mid-2011 around the adoption of Virtual Desktops (VDI) in healthcare.
By leveraging such technologies as SSO and VDI, hospitals are making progress towards adoption, but there is still a long way to go. As Figure 5 shows, 45% of the 211 respondents indicated that more than half of their physicians are placing orders via CPOE. When you look at CPOE adoption by department (Figure 6), hospitals rolled out to all departments have a higher adoption rate—showing the ultimate success, it’s rolled out AND it’s being used!