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The Commure Pro Computerized Physician Order Entry (CPOE) application is a complete order-entry application that saves time and simplifies order entry for health care providers. Commure Pro CPOE supports full integration with a facility’s existing systems. Instead of requiring hospitals to replace existing systems, CPOE is fully inter-operable with existing back-end systems, since it operates as an additional layer within a facility’s IT infrastructure. At a high level, the process for configuring the CPOE system involves the following items. Unless specifically noted, each step in this configuration process is assumed to be restricted to administrators in your facility with level 1 access.
  1. Configure your CPOE application preferences. This includes the following items:
    • Configure CPOE Facility Group preferences The Facility Group preferences are settings that control behavior of the CPOE application across an entire group of facilities within your institution. For example, you can set preferences to require a password for order submission, to specify a recipients list for critical alert notifications, and to control aspects of how orders display and function in the CPOE application. These preferences are applied to all users belonging to a particular Facility Group, unless an individual user setting overrides a Facility Group setting.
In deployments where Facility Groups are not enabled, the Facility Group tab is replaced by the CPOE tab.
Set the default CPOE preferences for all users within each of your institution’s Facility Groups. This includes other institution administrators (Level 1 users), department administrators (Level 2 users), and health care providers (Level 3 users).For more information, see Configuring Facility Groups.
  • Configure the location preferences for each of your facilities and units. Location preferences enable you to maintain specific information about each of your facilities and units. These preferences include settings to schedule meal times, printer data for each of your locations, and contact lists for system messages that pertain to each of your locations. For more information, see Configuring Locations.
  • Configure department-level preferences Department preferences in CPOE enable you to create any favorite orders that you want to be shared by all health care providers within one or more of your departments. For example, you might choose to create a list of favorite orders for an established specialty, a new group of incoming residents, or a department of new physicians without an order history.Depending on your configuration, department-level preferences in CPOE can be configured by administrators with either level 1 or level 2 access. For more information, see Configuring Department Settings.
  • Configure user-level preferences User preferences in CPOE enable you to create favorite orders for individual providers in your facility. Configuring favorites at the user level can be beneficial if you want to assign favorites with more granularity than at the department level. You can also enable and disable order entry, free-text order entry, and order search at the user level, as well as control an individual user’s access to the Medication Reconciliation feature.Depending on your configuration, user-level preferences in CPOE can be configured by administrators with either level 1 or level 2 access.
  1. Carefully review your existing orders and make any necessary changes. After all orders are brought over from your back-end system, it is essential that you review this data to ensure that your Order Definitions display correctly and that your orders are accurately categorized in the correct Order Types and Order Groups. To facilitate the review process, you can export all of your order data into a file that you can print, so that you can delegate review of specific Order Types or Groups to the appropriate departments to ensure a thorough and comprehensive review. For more information, see Exporting the Order Catalog for Review.
It is only possible to make limited changes to orders that are imported from your back-end system. In many cases, these changes are restricted to editing a few of the properties that are used to define the elements (Order Types, Groups, Fields, etc.) that categorize orders in the CPOE application. Any modification that you make to orders originating from your back-end system are likely to involve changing properties of these elements as follows:
  • Order Type properties Order Types are the elements used to generally classify orders. The CPOE application uses six Order Types: Diet, Lab, Medication, Nursing, Radiology, and Other. All orders must be assigned to one of these six types. In some environments, these types map directly to categories that exist in your institution’s back-end system; in other environments, this mapping must be performed manually. Your options for modifying Order Type properties are limited, because these types are hard-coded in the CPOE application. However, there are a few Order Type properties that you can modify, such as the work flows allowed by each Order Type. For more information, see Editing Order Type Properties.
  • Order Group properties Order Groups classify orders into more specific categories according to their use. An example of an Order Group is HEMATOLOGY. This Order Group (which belongs to the Lab Order Type) is used to classify several Order Definitions that are associated with this kind of test. As with Order Types, Order Groups that are created in a back-end system usually remain unchanged in the CPOE application, as most of their properties are available as read-only data only. However, since some Order Groups will not apply to the types of orders used by providers, configuration of Order Groups also involves hiding any of the groups that you identify as irrelevant to your providers’ workflow. For more information, see Editing Order Group Properties.
  • Order Definition properties Order Definitions are the actual orders that providers enter into the CPOE application. For example, COMPLETE BLOOD COUNT or HEMOGLOBIN A1C). These definitions are organized under an Order Group and Order Type. (In this example, both of these definitions belong to the HEMATOLOGY Order Group, which belongs to the Lab Order Type.)The CPOE application provides a few more options for editing Order Definitions, since you may want one or more specific orders to be handled differently from all other orders in their Order Group. For example, you may want only some of the definitions within an Order Group to automatically launch an Order Detail screen when providers select them during order entry. Note that, just as with Order Types and Order Groups, some aspects of Order Definitions (such as their names and abbreviations) must remain unchanged in the CPOE application when they are created using an interfaced back-end system. For more information, see Editing Order Definition Properties.
  • Field Sets and Fields A Field Set is used to group multiple Fields that are associated with a specific Order Group or Order Definition.Fields are the questions that prompt the provider to complete specific details when entering an Order Definition. Fields can be defined as required so that providers are forced to complete specific information before they are permitted to submit an order. Fields can take many forms, including check boxes, date and time fields, radio buttons, and text fields. In environments where Fields are not interfaced, there may be a need to create Fields directly in the CPOE application. You might need to create these Fields for non-medication Order Types, since the interfacing of these orders occurs independently from the medication order interface. In environments that interface Fields, is unlikely that you will need to modify Fields to existing orders that originated in a back-end system, since Fields belonging to back-end orders (except medication orders) remain unchanged to ensure consistency between the CPOE application and your facility’s back-end system. However, all of the Fields associated with back-end orders are brought into the CPOE application as hidden, so you must explicitly un-hide all Fields that you want to display to providers. For more information, see Working With Field Sets.
  1. Create any additional orders directly in the CPOE application. In a few specific cases, you may need to create orders directly in the Commure Pro CPOE application. Typically you must create orders when one or more groups in your facility enter orders using terminology that is unclear to your physicians. For example, pharmacy orders sometimes use different terms to denote the quantity of some types of medications.
For more information, see Creating Order Strings Manually.
  1. Define any favorite orders for your providers. You can define favorites to be shared by all users in a department, or for individual providers. These will be made available to providers in addition to any of the favorites that they create for themselves in the user interface. Configuration of favorites can include the following steps:
    • Define any favorite orders for one or more of your departments. If there are favorites that you want to be shared by all users within one or more of your departments, you can configure these on a per-department basis. For example, you may choose to make some orders available that are commonly placed by all of the hospitalists at your facility. Before you create favorites at the department level, you should have a thorough understanding of each department and its users so that you can create favorites that are useful to the entire group of users belonging to each department. For more information, see Defining Favorites for Your Departments.
  • Define any favorites for individual users. If there are any favorites that you want to define at the user level, you can also configure these on a per-user basis. You do not need to complete this step unless you want to configure favorite settings for individual users that differ from the favorite settings of the department (or departments) to which they belong. Also note that, since physicians are enabled to create their own list of favorites in the user interface, there may be no need for administrators to define favorites at the individual user level. For more information, see Creating a Favorites List for Individual Users.
  1. Configure routing for all orders in each of your facilities. In the CPOE application, orders are routed through each of your facilities according to route actions that you define. Route actions determine how to send orders (for example, based on their Order Group) to various destinations, such as a printer, file server, e-mail, or electronic interface. Configuration of routing includes the following steps:
    • Configure the Destinations for your route actions. Destinations are the places in your facility or institution where orders are to be printed, stored on a file server, or sent to an electronic interface where they are integrated with your facility’s back-end system. A destination can specify a network address for printers, file servers, e-mail, or electronic interfaces.Destinations are associated with a Destination Group. Destination Groups are used to define a Destination by its type. Frequently, a Destination Group is defined to be associated with a single Destination. For more information, see Creating Destination Groups and Defining Destinations.
  • Configure the Route Actions for your Order Groups. If your facility has not already defined how orders are routed through your institution, you must decide how to assign route actions to the various Order Groups that contain your orders. When assigning route actions to your Order Groups, you must consider who needs to receive the information when orders are placed, as well as the delivery method for this information. For more information, see Configuring Order Routing.