Streamlining Order Sets Governance

with Bidirectional EHR Integration

ORDER SET MANAGEMENT CHALLENGES
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BENEFITS OF EFFECTIVE ORDER SET MANAGEMENT
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HURDLES TO USE OF ORDER SET MANAGEMENT TOOLS
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VALUE OF BIDIRECTIONAL INTEGRATION
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Common Order Set Management Challenges

Through our research and clinical experience, we've discovered the three biggest challenges hospitals face when it comes to effective and successful order set management:
 

1. Order set governance and
    use in CPOE

2. Evidence-based and
    regulatory-compliant content

3. Consistent content and care

Order Set Governance and Use in CPOE

Order sets governance (creation, review, and/or updates) is traditionally a time consuming back and forth via email, red lining, and round table discussions with no true, robust way of tracking the process or coming to a consensus.

Even if an order set is created or updated, getting clinicians across a hospital, or multiple hospitals, to adopt a standardized version is very difficult.

Evidence-based and Regulatory Compliant Content

Order sets must have their basis in up-to-date, clinical evidence while simultaneously remaining compliant with regulatory measures. However, there are over two million scientific articles being published each year and the regulatory landscape is constantly changing.

Therefore, it’s extremely difficult for a clinician to feel confident that their recommendation on what should be included in an order set is consistent with the latest clinical evidence and regulatory measures. 

Consistent Content and Care

Ensuring consistent order set content as well as consistent patient care from provider to provider, hospital to hospital, service line to service line, is a challenge for many organizations.

Order set content should not only be consistent between one instance of an EMR and another, it should be consistent in all venues, including the downtime solutions used when EMR systems go offline. The result of ineffective order set management is inconsistent content and inconsistent care.

Order Set Governance and Use in CPOE

Order sets governance (the creation, review, and updating) is traditionally a time consuming back and forth process via email, red lining, and round table discussions with no true, robust way of tracking the process or coming to a consensus.

Even if an order set is created or updated, getting clinicians across a hospital, or multiple hospitals, to adopt a standardized version is a major challenge.

Evidence-Based & Regulatory Compliant Content

Order sets must have their basis in up-to-date clinical evidence while simultaneously remaining compliant with regulatory measures. However, there are over two million scientific articles being published each year and the regulatory landscape is constantly changing.

Therefore, it’s extremely difficult for a clinician to feel confident that their recommendation on what should be included in an order set is consistent with the latest clinical evidence and regulatory measures. 

Consistent Content and Care

Ensuring consistent order set content as well as consistent patient care from provider to provider, hospital to hospital, and service line to service line, is a challenge for many organizations.

Order set content should not only be consistent between one instance of an EMR and another, it should be consistent in all venues, including the downtime solutions used when EMR systems go offline. The result of ineffective order set management is inconsistent content and inconsistent care.

Order Set Governance and Use in CPOE

Order sets governance (creation, review, and/or updates) is traditionally a time consuming back and forth via email, red lining, and round table discussions with no true, robust way of tracking the process or coming to a consensus.

Even if an order set is created or updated, getting clinicians across a hospital, or multiple hospitals, to adopt a standardized version is very difficult.

Evidence-based and Regulatory Compliant Content

Order sets must have their basis in up-to-date, clinical evidence while simultaneously remaining compliant with regulatory measures. However, there are over two million scientific articles being published each year and the regulatory landscape is constantly changing.

Therefore, it’s extremely difficult for a clinician to feel confident that their recommendation on what should be included in an order set is consistent with the latest clinical evidence and regulatory measures. 

Consistent Content and Care

Ensuring consistent order set content as well as consistent patient care from provider to provider, hospital to hospital, service line to service line, is a challenge for many organizations.

Order set content should not only be consistent between one instance of an EMR and another, it should be consistent in all venues, including the downtime solutions used when EMR systems go offline. The result of ineffective order set management is inconsistent content and inconsistent care.

Order Set Governance and Use in CPOE

Governance (the creation, review, and updating) of order sets is traditionally a time consuming back and forth via email, red lining, and round table discussions with no true, robust way of tracking the process or coming to a consensus.

Even if an order set is created or updated, getting clinicians across a hospital, or multiple hospitals, to adopt a standardized version is very difficult.

Evidence-Based & Regulatory Compliant Content

Order sets must have their basis in up-to-date, clinical evidence while simultaneously remaining compliant with regulatory measures. However, there are over two million scientific articles being published each year and the regulatory landscape is constantly changing.

Therefore, it’s extremely difficult for a clinician to feel confident that their recommendation on what should be included in an order set is consistent with the latest clinical evidence and regulatory measures. 

Consistent Content and Care

Ensuring consistent order set content as well as consistent patient care from provider to provider, hospital to hospital, service line to service line, is a challenge for many organizations.

Order set content should not only be consistent between one instance of an EMR and another, it should be consistent in all venues, including the downtime solutions used when EMR systems go offline. The result of ineffective order set management is inconsistent content and inconsistent care.

Benefits of Effective Order Set Management

The volume of complex clinical information being collected by hospitals and health systems has exploded in recent years, as have the types of clinical decision support tools that use this information to drive clinical improvement. From order sets and care plans to prescribing guidance and clinical decision support rules, healthcare organizations today bear the responsibility of ensuring the clinical knowledge they have amassed is properly delivered and properly maintained.

As the body of encoded clinical knowledge contained within EMRs and other health IT systems grows, healthcare organizations must deploy efficient clinical knowledge management processes to ensure it is kept current and responsibly managed. It is a momentous challenge, one that many healthcare executives are just now beginning to contemplate, but the benefits are worth the effort.

Although it is a hefty challenge in its own right, the process of acquiring clinical content and deploying it into a clinical decision support framework and infrastructure is one that has been navigated across the industry with varying degrees of success. And while these are important first steps, what happens when the evidence changes or becomes dated?
clinical knowledge management can be a weightier responsibility than the initial deployment of clinical content into clinical decision support. It requires effective governance over not only the acquisition and incorporation of content but also the regular review and update of the clinical information assets that are delivered at the point of care.
 
Although it is a hefty challenge in its own right, the process of acquiring clinical content and deploying it into a clinical decision support framework and infrastructure is one that has been navigated across the industry with varying degrees of success. And while these are important first steps, what happens when the evidence changes or becomes dated?
Clinical knowledge management can be a weightier responsibility than the initial deployment of clinical content into clinical decision support. It requires effective governance over not only the acquisition and incorporation of content but also the regular review and update of the clinical information assets that are delivered at the point of care.
 

Effective Order Set Management

Many organizations are now embracing the need to address clinical knowledge management. However, dedicating the resources needed to keep up with rapidly evolving standards of care can often be an unrealistic proposition.  In addition to the challenge of keeping up with the 2 million scientific articles published annually, the Centers for Medicare and Medicaid Services (CMS) and private payers are placing greater emphasis on the practice of evidence-based medicine, including linking performance on core measures and outcomes to reimbursements.

Simply put, the major trends in healthcare emphasize delivering higher quality at a lower cost. The organizations that are best positioned to accomplish this are those that provide clinicians with access to the best clinical advice at the point of care-which requires a formal strategy for clinical knowledge management.

Effectively managing the lifecycle of clinical knowledge embedded in clinical decision support applications necessitates identification of appropriate leadership and governance processes, as well as the deployment of effective tools to automate the process of acquiring, tracking and managing these assets.

Historical Hurdles to Use of Content Management Tools with Epic

Integration has typically been one direction, and the absence of accurate, efficient bidirectional content movement historically resulted in:

  • Ensuring and maintaining content is consistent across multiple locations (CPOE, downtime, knowledge management software)
  • Significant orderable maintenance (additions, deletions, change orders, details, etc.)

These hurdles consequently result in a divergence of the content between systems over time, a high demand for resources, and content that is not maintained as completely or as frequently as it should be. 

The Ideal Order Set Management Tool

Up-to-Date,
Evidence-Based
Content

Up-to-Date, Evidence-Based Content

Up-to-Date, Evidence-Based Content

Up-to-Date, Evidence-
Based Content

The tool must have
evidence that is up
-to-date and
stems from a well
-trusted source
 that can serve as a 
referee
between clinicians who 
have
differing opinions on what 
should
be included in an
order set. 

The tool must have evidence that is up-to-date and stems from a well-trusted source that can serve as a referee between clinicians who have differing opinions on what should be included in an order set. 

The tool must have evidence that is up-to-date and stems from a well-trusted source that can serve as a referee between clinicians who have
differing opinions on what 
should be included in an order set. 

User Friendly

User Friendly

User Friendly

User Friendly

The tool must be user friendly—something that clinicians feel comfortable  using as ease of use is essential to adoption. It should also function efficiently and intuitively from one device to another.

The tool must be user friendly—something that clinicians feel comfortable 
using as ease of use is essential to adoption. It should also function efficiently and intuitively from one device to another.

The tool must be
user friendly—something
that clinicians feel comfortable
using as ease of use is
essential to adoption. It should
also function efficiently and
intuitively from one
device to another.

Governance and Archiving

Governance and Archiving

Governance and Archiving

Governance and Archiving

The tool must include a robust way to represent complex governances. Clinicians need to be able to archive and track all edits, updates, and adjustments made to their order sets.

The tool must include a robust way to represent complex governances. Clinicians need to be able to archive and track all edits, updates, and adjustments made to their order sets.
The tool must
include a
 robust way to
represent complex governances. Clinicians need
to be able to archive and track
all edits, updates, and
adjustments made to
their order sets.

Content Management

Content Management

Content Management

Content Management

Many systems have over 1,000 order sets so the ability to create global edits is essential. It is important to have an efficient means of managing and flagging items that need to be reviewed.

Many systems have over 1,000 order sets so the ability to create global edits is essential. It is important to have an efficient means of managing and flagging items that need to be reviewed.
Many systems
have over 1,000 order
sets so the ability to create
global edits is essential. It
is important to have an effi-
cient means of managing and
flagging items that need
to be reviewed.

Integrated with CPOE System

Integrated with CPOE System

Integrated with CPOE System

Integrated with CPOE System

The tool must integrate with the CPOE system to ensure consistency across systems, ease of importing and exporting new order sets, and enabling efficient maintenance of the order set library.

The tool must integrate with the CPOE system to ensure consistency across systems, ease of importing and exporting new order sets, and enabling efficient maintenance of the order set library.

The tool must
integrate with the CPOE
system to ensure consistency
across systems, ease of
importing and exporting new
order sets, and enabling effi-
cient maintenance of the
order set library.

Advanced Bidirectional Integration:
The ProVation Order Sets Differentiator

For years, hospitals focused on building order set libraries for meaningful use of CPOE. However, when it comes to leveraging that investment to drive quality-based outcomes and reimbursement, many hospitals are now struggling with the time and effort involved in ongoing order set governance.
 
Resources being limited, manually entering order sets from one system to another simply is not scalable. That's why we developed the ability to import our customers’ content while keeping all of the robust maintenance functionality. ProVation Order Sets can handle the very detailed data around each SmartSet and its supporting SmartGroups and Panels, all the while keeping content consistent across Epic and ProVation Order Sets. Bidirectional integration streamlines a process that traditionally takes anywhere from 5-7 hours down to minutes.

ProVation Order Sets and Epic Bidirectional Integration Benefits

  • Governance, evidence, and downtime solutions are available while working with familiar content and structure
  • SmartSet import into ProVation Order Sets and export to Epic
  • SmartGroup and Panel information imported and  retained in ProVation Order Sets
  • Order sets utilizing SmartGroups and Panels retain all attributes and selected attribute values on export
  • Orders within SmartGroups and Panels are imported with all their order details and selected values
  • All imported SmartSet information is easily exported to Epic

Want to learn more about ProVation Order Sets?

Check out our information sheet!

Download Information Sheet

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