Author Question: An unintended consequence associated with the use of an electronic health system occurs when: a. ... (Read 90 times)

saliriagwu · **on:** Jul 8, 2018

An unintended consequence associated with the use of an electronic health system occurs when:

a. a physician places a medication order with an inappropriate drug dose for a pediatric patient in a CPOE system.
b. a physician enters orders on a patient who was incorrectly selected from a drop-down list of the physician's personal patient list.
c. a nurse enters a telephone order from the attending physician into the electronic health system and fails to read back the order.
d. a nurse enters PRN pain medication orders on a patient and fails to record the indications for each pain medication.

Question 2

A large medical center that specializes in high-risk pregnancies is implementing an entire suite of clinical applications such as CPOE, barcode medication administration (BCMA), nursing documentation,

data acquisition system to collect clinical data from cardiac and fetal monitors and ventilators, laboratory system, radiology system, PACS, and cardiology. It has a large, highly skilled, experienced IT team. The project team decided to go with a Big Bang go-live versus an incremental or phased approach. Which factor best supports this decision?

a. The Big Bang approach decreases the possibility of errors.
b. The incremental approach is best for hospitals with large IT departments.
c. The Big Bang approach minimizes overall productivity loss.
d. The incremental approach normally has lower implementation costs.

cloudre37 · **Reply #1 on:** Jul 8, 2018

Answer to Question 1

ANS: B
The physician entering orders on a patient who was incorrectly selected from a drop-down list of the physician's personal patient list would be an example of an unintended consequence. The other responses are examples of behaviors that are not unique to orders placed in an EHR and can occur in a paper system as well.

Answer to Question 2

ANS: A
Big Bang decreases the possibility of errors because physicians do not have to use different workflows in different departments or units. Users also have high levels of support in the initial days. Big Bang will have a major impact on productivity initially with a gradual return to baseline. The incremental approach is best suited for organizations with small IT departments and minimal support personnel. It also typically will increase the overall costs of the project.