• Logo
  • HamaraJournals

Modeling of Computerized Physician Order Entry with Decision Support System for Diabetic Patients

Leila Shahmoradi, Marjan Ghazi Saeedi, Safieh Ilati Khangholi, Arezoo Dehghani Mahmoodabadi
76

Views


Abstract

Introduction: Providing care for patients and preventing complications is one of the major subjects in medical sciences. Computerized Physician Order Entry (CPOE) with a decision support system is expected to deliver many benefits. A system with decision support system may help clinicians, patients, and others to suggest patient-appropriate evidence-based treatment options.The present study was conducted to prepare a conceptual model for a CPOE system of diabetic patients (Type 2) using Unified Modeling Language (UML). Then, a software program was designed accordingly.

Method: This cross-sectional study was conducted in 2017. A minimum data set of patient records was used as the patient profile in the system, and a list of drugs and functional requirements of the CPOE system for diabetic patients was provided. Following the confirmation of the minimum data set by diabetes specialists, UML figures were drawn and the software was designed.

Results: The minimum data set of patient records included demographic and clinical information as well as laboratory tests. Functional requirements of the CPOE system for type 2 diabetic patients consisted of the possibility of recording simple and complicated orders, connecting the system to the pharmacy or other auxiliary information systems, controlling drug side effects, etc.

Conclusion: A CPOE system should have minimum errors in documentations and provide information on allergies, drug interactions, and side effects in a timely manner to reduce medical errors, especially drug errors, increase physician efficiency and patient satisfaction, and finally promote the quality of healthcare services.


References

Cox AR, Ferner RE. Prescribing errors in diabetes. The British Journal of Diabetes & Vascular Disease. 2009; 9(2): 84-8.

Pennsylvania Patient Safety Authority. Medication errors with the dosing of insulin: Problems across the continuum. Pennsylvania Patient Safety Advisory. 2010; 7(1): 17-9.

Moghaddasi H, Sheikhtaheri A, Hashemi N. Reducing medication errors: Role of computerized physician order entry system. Journal of Health Administration. 2007; 10(27): 57-67.

Ariaei M, Nejad AS, Kouti J, Mehdipour Z, Bahaadinbeigy K. Role of clinical decision supporting systems in prevention of medical errors from the perspective of health care staff in university hospitals of Kerman university of medical sciences. Health Information Management. 2012; 9(5): 712-23.

Mansouri A, Ahmadvand A, Hadjibabaie M, Javadi M, Khoee SH, Dastan F, et al. A review of medication errors in iran: sources, underreporting reasons and preventive measures. Iran J Pharm Res. 2014; 13(1): 3–17. PMID: 24734052

Steele AM, DeBrow M. Efficiency gains with computerized provider order entry. In: Henriksen K, Battles JB, Keyes MA (eds.). Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 4: Technology and Medication Safety). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008.

Galanter W, Falck S, Burns M, Laragh M, Lambert BL. Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE). J Am Med Inform Assoc. 2013; 20(3): 477-81. PMID: 23396543 DOI: 10.1136/amiajnl-2012-001555

Agrawal A. Medication errors: prevention using information technology systems. Br J Clin Pharmacol. 2009; 67(6): 681–6. PMID: 19594538 DOI: 10.1111/j.1365-2125.2009.03427.x

Khajouei R, Jaspers M. The impact of CPOE medication systems' design aspects on usability, workflow and medication orders. Methods Inf Med. 2010; 49(1): 3-19. PMID: 19582333 DOI: 10.3414/ME0630

Nuckols TK, Smith-Spangler C, Morton SC, Asch SM, Patel VM, Anderson LJ, et al. The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: A systematic review and meta-analysis. Syst Rev. 2014; 3: 56-68. PMID: 24894078 DOI: 10.1186/2046-4053-3-56

Sharifi N, Alipour A, Ranjbar K. The effect of modern educational strategies in reducing intravenous drug administration error: A non-randomized clinical trial. Iranian Journal of Medical Education. 2012; 11(6): 590-9.

Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety: A systematic review. Arch Intern Med. 2003; 163(12): 1409-16. PMID: 12824090 DOI: 10.1001/archinte.163.12.1409

Levick DL, Stern G, Meyerhoefer CD, Levick A, Pucklavage D. Reducing unnecessary testing in a CPOE system through implementation of a targeted CDS intervention. BMC Med Inform Decis Mak. 2013; 13: 43-50. PMID: 23566021 DOI: 10.1186/1472-6947-13-43

Doolan DF, Bates DW. Computerized physician order entry systems in hospitals: Mandates and incentives. Health Aff (Millwood). 2002; 21(4): 180-8. PMID: 12117128 DOI: 10.1377/hlthaff.21.4.180

Esteghamati A, Larijani B, Aghajani MH, Ghaemi F, Kermanchi J, Shahrami A, et al. Diabetes in Iran: Prospective analysis from first nationwide diabetes report of national program for prevention and control of diabetes (NPPCD-2016). Sci Rep. 2017; 7(1): 13461-71. PMID: 29044139 DOI: 10.1038/s41598-017-13379-z

Valizadeh R, Vali L, Bahaadinbeigy K, Amiresmaili M. The challenges of Iran’s type 2 diabetes prevention and control program. Int J Prev Med. 2019; 10(1): 175.

World Health Organization. Global report on diabetes. 2016.

Farshchi A, Esteghamati A, Sari AA, Kebriaeezadeh A, Abdollahi M, Dorkoosh FA, et al. The cost of diabetes chronic complications among Iranian people with type 2 diabetes mellitus. J Diabetes Metab Disord. 2014; 13(1): 42-56. PMID: 24593991 DOI: 10.1186/2251-6581-13-42

Riazi H, Larijani B, Langarizadeh M, Shahmoradi L. Managing diabetes mellitus using information technology: A systematic review. J Diabetes Metab Disord. 2015; 14: 49-58. PMID: 26075190 DOI: 10.1186/s40200-015-0174-x

Dennis A, Wixom BH, Tegarden D. Systems analysis and design: An object-oriented approach with UML. John Wiley & Sons; 2015.

Evans A, France R, Lano K, Rumpe B. Developing the UML as a formal modelling notation. In: Pierre-Alain Muller, Jean Bezivin (eds.). UML'98 eyond the notation. International Workshop Mulhouse France. Universite de Haute-Alsace. 1998.

deLusignan S. Benefits and disbenefits of the implementation and adoption of computerised medical records (CMR); plus a more accessible approach to modelling. BMJ Health Care Informatics. 2016; 23(1): i-ii.

Hosseini A, Moghaddasi H, Jahanbakhsh M. Designing minimum data sets of diabetes mellitus: Basis of effectiveness indicators of diabetes management. Health Information Management. 2010; 7(3): 330-40.

Ahmadi M, Ghazisaeidi M, Bashiri A. Radiology reporting system data exchange with the electronic health record system: A case study in Iran. Glob J Health Sci. 2015; 7(5): 208-14. PMID: 26156904 DOI: 10.5539/gjhs.v7n5p208

Riazi H, Langarizadeh M, Larijani B, Shahmoradi L. Conceptual framework for developing a diabetes information network. Acta Inform Med. 2016; 24(3): 186-92. PMID: 27482133 DOI: 10.5455/aim.2016.24.186-192

Jung E-Y, Kim J, Chung K-Y, Park DK. Mobile healthcare application with EMR interoperability for diabetes patients. Cluster Computing. 2014; 17(3): 871-80.

Amanzadeh M. Conceptual model of CPOE. [Thesis] Shahid Beheshti University: Tehran; 2010.

Samadbeik M. Conceptual model for a national system of electronic prescribing. [Thesis] Tehran University of Medical Sciences: Tehran; 2013.

Ahlan AR, Ahmad BI. An overview of patient acceptance of health information technology in developing countries: A review and conceptual model. International Journal of Information Systems and Project Management. 2015; 3(1): 29-48.

Shajarat M. Assessment of individual EHR information elements of diabetes base on mobile. [Thesis]. Tehran University of Medical Science: Tehran; 2012.

Sadeghi F. The design of a reconstructive hand surgery text database based on a speech recognition system. [Thesis]. Tehran University of Medical Science: Tehran; 2013.

Coustasse A, Shaffer J, Conley D, Coliflower J, Deslich S, Sikula A. Computer Physician Order Entry (CPOE): Benefits and concerns-a status report. Journal of Information Technology Research. 2013; 6(3): 16-31




DOI: http://dx.doi.org/10.30699/fhi.v9i1.206

Refbacks

  • There are currently no refbacks.