Informatics Research Seminar: CPOE, Alerts and Workflow

December 1 @ 4:00 – 5:00 pm

Speaker: Dr. Jos Aarts
Presented from Duke University


Ten years ago research of the impact of health information technology (HIT) on medical work practices started at Erasmus MC. The research is characterized by practice driven field research. From the beginning computerized physician order entry systems (CPOE) were a major topic. Research questions were how implementation of CPOE could be understood, how physicians were responding to reminders and alerts and how CPOE impacted professional workflow and collaboration. Studies of CPOE implementation aimed to understand why the adoption rate is so low and riddled with difficulties. Studies of reminders and alerts addressed the problem of alert fatigue. Finally, studies of workflow explored how CPOE influenced clinical workflow and how simplistic and linear models underlying CPOE may lead to poorly designed systems and even compromise patient safety. Findings include the need for a shared understanding of medical challenges when implementing CPOE, conceptual models to understand alert fatigue and medical workflow and the impossibility of agreeing which alerts to suppress hospital-wide. The underlying research principle is the sociotechnical approach, which stipulates that technology, people and organizations should be studied from a single theoretical perspective. This presentation summarizes the results of ten years of research.


Dr. Jos Aarts is a senior research scientist at the Institute of Health Policy and Management and the Department of Medical Informatics of Erasmus University Rotterdam in the Netherlands. He is also a visiting research fellow at the University of Pennsylvania, Philadelphia. His general scientific interest is the impact of information technology on clinical work practices. His current interests are electronic prescribing and decision support systems and impact of health IT on clinical workflow. His PhD thesis was on the implementation of computerized physician order entry systems in Dutch and American hospitals. His research papers on CPOE have appeared in Health Affairs, the Journal of American Medical Informatics Association, the International Journal of Medical Informatics and Methods of Information in Medicine. Dr. Aarts has been a visiting scientist at Oregon Health and Science University, Portland, Ore, and the University of New South Wales and the University of Sydney in Australia. He is chair of Working Group Human and Organizational Factors of Medical Informatics of the European Federation for Medical Informatics. He is chair-elect of AMIA’s People and Organizational Issues Working Group. He is on the editorial board of the International Journal of Medical Informatics. Dr. Aarts is chair of the Scientific Program Committee of Medical Informatics Europe 2011, which will be held in Oslo, Norway, from August 28 to 31, 2011.