Pressure on the healthcare industry to widely implement CPOE systems is coming from many areas, including publicity about the number of deaths at U.S. hospitals each year that are caused by medical errors, industry organizations voicing concern for improved patient safety, the increase in state legislation aimed at reducing the incidence of medical errors, and the need for hospitals to reduce liability costs by reducing medical errors. Despite this pressure, after over 30 years of CPOE availability, only 3 percent of hospitals have successfully implemented enterprise-wide CPOE systems according to the 2002 Back Beats Survey conducted by Healthcare Informatics.

In contrast to CPOE, handheld devices and other mobile technologies have followed a significantly steeper adoption curve in healthcare. With the penetration of handheld devices growing along with the demand for CPOE, the obvious conceptual integration is to implement full CPOE functionality on handheld devices. Today, IT vendors, hospitals, and clinicians are trying to merge these two trends into "CPOE on a handheld." They expect to have full functionality on all platforms: computer workstations, rolling laptops, tablet PCs, and handheld devices.

Debating the Future of CPOE
MercuryMD, a private, healthcare-focused software company that provides hospitals with mobile technology solutions, believes that the widespread adoption of CPOE and mobile technology in healthcare will come about only through the adoption of a new category of systems it calls "mobile physician order entry," or MPOE.

The company argues that adoption of MPOE systems will be driven by easy-to-use, intelligently limited, high-yield functions that do not merely mimic comprehensive CPOE systems onto smaller devices, but are different from CPOE in form, function, and implementation. By recognizing the importance of MPOE as a distinct product category, MercuryMD believes that hospitals can implement MPOE systems to accomplish different goals depending on the stage of their overall "order entry" strategy.

"CPOE systems are complex and require substantial user training for appropriate use. Even with all the CPOE-relevant benefits of computer workstations, like large screens, keyboards, fast processing power, mice, comfortable chairs, and time-intensive training initiatives, the adoption rate for CPOE is quite low," explains Alan Ying, CEO at MercuryMD. "It seems unreasonable to expect sudden, enthusiastic industry adoption by replacing CPOE-friendly computer workstations with the tiny screens, slower processing power, and reduced connectivity of mobile devices, while maintaining all the complexities of full-function CPOE system. Yet this is exactly what the industry is growing to expect and demand."