BACKGROUND
Electronic standard order sets automate ordering of specific treatment, testing and investigative protocols by physicians. Despite their routine implementation within Electronic Medical Records (EMRs), little is understood regarding how they are used and what are the factors’ that influence their adoption in practice.
OBJECTIVE
This study aimed to i) describe patterns of use of standard order sets within a multi-hospital healthcare system; and ii) explore and map clinicians’ perceptions of use to a behavioural model (COM-B).
METHODS
Quantitative data on standard order sets use from five hospitals was captured over five-month intervals for three years (2019, 2020, 2021). Qualitative Data comprising of unstructured and semi-structured interviews (n=15) was collected and analysed using a reflexive thematic approach. Interview themes were then mapped to a theory-informed model of behaviour change (COM-B) to identify determinants of use in routine clinical practice.
RESULTS
Total count of standard order sets use across the health system in the 2019 observation period was 267 253, increasing to 293 950 and 335 066 in 2020 and 2021, respectively. There was a change in use toward specialty order sets that had received upgrades in the study period. There were four emergent themes related to order set use derived from clinician interviews: i) Knowledge and Skills; ii) Perceptions; iii) Technical Dependencies; and iv) Unintended Consequences which were mapped to the COM-B model. Findings suggest a user preference for customised order sets, in response to local context and user experience.
CONCLUSIONS
Sustained and continuous uptake for appropriate CPOE use may require implementation strategies associated with capability, opportunity, and motivational influencers of behaviour.
CLINICALTRIAL
NA