CPOE (Computerized Provider Order Entry), is the direct entering of orders into a computer (or mobile device), so that the order is documented in a digital, structured, and computable format.
Meaningful Use Core Measure: CPOE
More than 30% of unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE.
Exclusion: providers who write fewer than 100 prescriptions during the reporting period.
CPOE is one of the measures that elicited quite an animated response from the provider community. When initially proposed, this measure required 80% of all orders to be directly entered by the provider. To overcome objections to the scope of the requirement and the burden it would impose, CMS ultimately limited the measure to medication orders and reduced the threshold to 30%. (The proposal for Stage 2 reinstitutes lab and radiology orders, but the requirements have not yet been finalized.)
There was also a great deal of conversation about who has to enter the order into the EHR—does it have to be the authorizing physician him/herself? This is the only measure in the Final Rule in which CMS addresses who can perform the function, identifying “…any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.” While some providers are unsure about where these specific guidelines can be found, CMS does provide further guidance, stating that CPOE should be done by someone who can exercise clinical judgment and take action based on the alerts and/or clinical decision support information that the order might generate.
Because for now CPOE is limited to medication orders, it is accomplished either in the course of ePrescribing or by using the same workflow but not transmitting the prescription electronically, (e.g., when prescribing controlled substances or prescribing for patients who request a printed prescription.) All of these prescriptions count in the numerator of this meaningful use measure because they are entered into the EHR.
Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.