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PSNet: Patient Safety Network
Journal Article

Sustained user engagement in health information technology: the long road from implementation to system optimization of computerized physician order entry and clinical decision support systems for prescribing in hospitals in England.

Cresswell KM, Lee L, Mozaffar H, et al. Health services research. 2017;52:1928-1957.

Computerized provider order entry and clinical decision support are patient safety strategies with significant implementation challenges. This qualitative study aimed to characterize engagement with these two activities across multiple hospitals in the United Kingdom. Investigators conducted interviews, employed direct observation, and reviewed documents such as implementation plans. Their analysis demonstrated a need for ongoing platform improvement (including bug fixes and local tailoring) and for monitoring how these two strategies are used to provide feedback and ensure optimal use. They conclude that in order to realize the benefits of computerized provider order entry and clinical decision support, hospitals must work with frontline staff over time, not just prior to implementation. In a previous PSNet interview, Dr. Robert Wachter discussed the challenges of implementing health information technology.