Stage 2 CPOE: Challenges and Opportunities for Providers

Providers beware: computerized physician order entry (CPOE) is set to create headaches for the healthcare community. In fact, the threshold requirements for providers to achieve Meaningful Use (MU) under Stage 2 have many concerned that they will encounter similar problems to the ones they experienced during Stage 1 attestation, just more of them.

CPOE is proving difficult for the entire industry. Research conducted by the University of Florida found that only 13 percent of hospitals that intended to participate in the incentive program received an incentive payment in 2011. Fifty percent of organizations that did not successfully attest reported that meeting CPOE was their primary challenge. The report also indicated that unlike some of the other Stage 1 criteria, CPOE presented a host of technological, cultural and organizational barriers that are expected to grow as the threshold requirements increase.1

According to CMS’s Stage 2 requirements for CPOE, eligible providers (EPs) must reach a 60 percent threshold for electronic medications, up from 30 percent with Stage 1. But as providers are well aware, that may be the easier measure to achieve. They are not looking forward to the criteria surrounding laboratory and radiology orders, which have been added as a core measure. EPs are required to reach a 30 percent threshold for both radiology and laboratory orders, with one exception: Any EP who writes fewer than 100 radiology or lab orders during the 90-day reporting period is exempt.

Perhaps the greatest challenge for physicians to overcome is the disruption that electronic orders are expected to have on workflow. While software developers will attempt to make it as easy as possible for providers to create electronic orders with multiple labs and radiology centers, the truth is that this electronic capability is simply not one that practitioners have typically dabbled in extensively. Providers can spend the remaining time in 2013 to familiarize themselves with their Electronic Healthcare Record’s (EHR) radiology and lab modules in readiness for Stage 2. And they should not be afraid to check with their vendors if they experience any difficulties on the road to MU compliance.

Challenges aside, providers should be encouraged by the fact that they can increase patient safety and ultimately streamline billing and claims activities with cleaner, more accurate electronic laboratory and radiology orders and results.

[1] Healthcare IT News. “CPOE biggest barrier to meaningful use, study finds.” September 28, 2012.

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