Any organization that has implemented computerized physician order entry systems has learned the project is fraught with technological and cultural minefields.

The clinical decision support that goes with CPOE changes clinician workflow beyond what the basic technology already does, with such potential intrusions as forced documentation templates, alerts and pop-ups. To ease the process, three-hospital Lehigh Valley Health Network in Allentown, Pa., started implementing CPOE in 2001, incrementally adding decision support functions over time, and waiting for four years until mandating its use.

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