Facilitating the development of evidence-based order sets and care pathways: lessons learned from an academic medical centre's implementation of a new electronic health record

Electronic health records (EHRs) that include computerized provider order entry (CPOE) have the potential to reduce medical errors and adverse drug events, improve health outcomes and reduce health care costs. The success of CPOE is dependent upon the development of standardized evidence-based order sets and care pathways that are developed and used by clinical providers. However, development is dependent upon the engagement and clinical expertise of health care providers who are busy caring for patients and may not have the time or resources to devote to order set development. This paper describes one academic institution's experience in adopting a new EHR that includes CPOE and the efforts to stimulate the development of order set content throughout all clinical sections and departments. Based on this experience, specific recommendations and guidance to facilitate the development of evidence-based order set and care pathway content are described in the article. Through the use of the described strategies and techniques, over a three-year period the institution developed, approved and implemented 495 order sets authored by 141 different providers and well exceeded the established goals of the committee and institution.