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Many organizations who use or want to use Order Sets, choose Evidenced Based order sets, which are a significant expense and most often require a subscription to a 3rd party vendor. Smaller organizations, which usually cannot afford the subscription maintenance, should consider the Cerner Model Order Sets as part of their Cerner Implementation. These order sets are based on what other Cerner clients designed, and use within their organization. When using these order sets, organizations need to consider some of the following information, as they develop or utilize the data in the model order set that will be used as part of their clinical operations.

Cerner Model Order Sets should:

  • Address regulatory and professional practice standards
  • Assure that Order Sets support the mission, values, and operations of the Organization
  • Be standardized based on best practices, or evidence-based literature, from across Ellis Medicine and leading practices from other healthcare organizations
  • Be based on the 80/20 rule, e.g., sufficient for 80% of the situations versus a perfect solution
  • Be based on what is best for your organization as a whole, and not what is solely best for an individual, facility, or unit
  • Be made with appropriate cross-representation of stakeholders, disciplines, and facilities
  • Be patient-centered and support continuity of care across the continuum
  • Consider individualization, where acceptable to support a legitimate business, need such as found in local variations of services provided or specialty
  • Follow a consistent methodology
  • Support the Organization’s commitment to convert from a primary paper order(s) (where applicable) and physician documentation to an electronic, paperless ordering process
  • Support Physician and Clinician adoption across the Organization’ enterprise
  • Support process changes to drive improvements in care provider efficiency and effectiveness
  • Focus on eliminating duplication of data and enhancing access to data, supporting clinical decision-making and communication, eliminating variability of care and driving improvements in quality
  • Maximize the functionality of available technology

Remember the Majority of Physician Opinions believe:

Speed Is Everything
Fewer Clicks
The fewer clicks, the better
Must fit into my Workflow
  • Little things can make a big difference. Adding frequently used tests, or frequently ordered tests by specialty-not approved for the order set in “Favorites” or (where there are multiple physicians of the same specialty, that want to use different ordering patterns for the same tests)
  • If alerts or pop-ups are leveraged, review of pop-ups with questions and alerts. Recognize that physicians will strongly resist stopping to read alerts, so we do not want to create alert fatigue on this journey

In summary, order sets should be flexible enough that they can be used on a variety of patients, and should be designed by a multi-disciplinary team so that all applicable requirements, i.e., pharmacy, laboratory, etc. are in the order sets. Lastly, make order sets a part of the organization’s change control processes.

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Jeanene Genusa

Vice President and Implementation Executive

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