RESEARCH ARTICLE


Behavioral Health Order Sets in a Hybrid Information Environment



John Strauss*, Peggy Olbrycht, Vincent Woo
Centre for Addiction and Mental Health, Toronto, Canada


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© John Strauss; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Centre for Addiction and Mental Health, 1001 Queen St. W., Toronto, ON, M6J 1H4, Canada; Tel: 416 254 3413; Fax: 416 583 1367; E-mail: john.strauss@camh.ca,


Abstract

Introduction:

The Centre for Addiction and Mental Health (CAMH) is a 500 bed freestanding psychiatric hospital in Canada. We are in the process of preparing for an integrated commercial clinical information system, which will have computerized physician order entry (CPOE) functionality.

Methods:

As a preparation for CPOE, we developed inpatient order sets (OSs). Development teams from individual clinical programs created and sent their OSs to an OS Working Group for initial endorsement, and then to Pharmacy & Therapeutics and Medical Advisory committees subsequent approvals.

Results:

In twelve months we created and introduced 22 behavioral health OSs across eight clinical programs in our hybrid information system with an excellent adoption rate (>97%) by clinicians.

Discussion:

The development and implementation temporarily contributed to a multifactorial flow problem in the emergency department (ED), which was addressed by substantially simplifying the General Admission via the ED OS. Also, as the OSs were developed and sent for approval the project identified areas where local clinical practice can improve. Our electronic-paper hybrid set of clinical systems was a major factor impacting the effort.

Keywords: : Order sets, behavioral health, EMR.