Effectiveness of Evidence-based Pneumonia CPOE Order Sets Measured by Health Outcomes

Authors

  • Jacob Krive Valence Health Advocate Health Care University of Illinois at Chicago Nova Southeastern University
  • Joel S. Shoolin Advocate Health Care
  • Steven D. Zink Nevada System of Higher Education

DOI:

https://doi.org/10.5210/ojphi.v7i2.5527

Abstract

Objective

Evidence-based sets of medical orders for the treatment of patients with common conditions have the potential to induce greater efficiency and convenience across the system, along with more consistent health outcomes. Despite ongoing utilization of order sets, quantitative evidence of their effectiveness is lacking. In this study, conducted at Advocate Health Care in Illinois, we quantitatively analyzed the benefits of community acquired pneumonia order sets as measured by mortality, readmission, and length of stay (LOS) outcomes.

Methods

In this study, we examined five years (2007–2011) of computerized physician order entry (CPOE) data from two city and two suburban community care hospitals. Mortality and readmissions benefits were analyzed by comparing “order set” and “no order set” groups of adult patients using logistic regression, Pearson’s chi-squared, and Fisher’s exact methods. LOS was calculated by applying one-way ANOVA and the Mann-Whitney U test, supplemented by analysis of comorbidity via the Charlson Comorbidity Index.

Results

The results indicate that patient treatment orders placed via electronic sets were effective in reducing mortality [OR=1.787; 95% CF 1.170-2.730; P=.061], readmissions [OR=1.362; 95% CF 1.015-1.827; P=.039], and LOS [F (1,5087)=6.885, P=.009, 4.79 days (no order set group) vs. 4.32 days (order set group)].

Conclusion

Evidence-based ordering practices have the potential to improve pneumonia outcomes through reduction of mortality, hospital readmissions, and cost of care. However, the practice must be part of a larger strategic effort to reduce variability in patient care processes. Further experimental and/or observational studies are required to reduce the barriers to retrospective patient care analyses.

Keywords: evidence-based medicine, medication order sets, health outcomes research, pneumonia, computerized physician order entry (CPOE).

Author Biographies

Jacob Krive, Valence Health Advocate Health Care University of Illinois at Chicago Nova Southeastern University

Project Manager, Population Health Technology Business Unit, Valence Health

Project Manager, Department of Information Systems, Advocate Health Care

Clinical Assistant Professor, Department of Biomedical and Health Information Sciences, School of Applied Health Sciences, University of Illinois at Chicago

Adjunct Assistant Professor, Department of Biomedical Informatics, School of Osteopathic Medicine, Nova Southeastern University

Joel S. Shoolin, Advocate Health Care

Family Physician, Department of Family Medicine, Advocate Medical Group

Steven D. Zink, Nevada System of Higher Education

Vice Chancellor for Information Technology, Administration, Nevada System of Higher Education

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Published

2015-05-31

How to Cite

Krive, J., Shoolin, J. S., & Zink, S. D. (2015). Effectiveness of Evidence-based Pneumonia CPOE Order Sets Measured by Health Outcomes. Online Journal of Public Health Informatics, 7(2). https://doi.org/10.5210/ojphi.v7i2.5527

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Section

Original Articles