Order Creation and Communication in Healthcare

Paul N. Gorman, M. B. Lavelle, J. S. Ash

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


Objectives: The aim of this paper is to examine the adequacy of the concept of Physician Order Entry (POE) as a model for clinical systems, and to suggest an alternative understanding of the order creation and communication process. Methods: The study is based on an interpretative analysis of POE as a model for clinical systems and the results of our recent fieldwork. Results: Observations from our recent fieldwork suggest that orders, like patient care in general, emerge from interactions among patients, physicians, nurses, family members and others, employing a variety of technologies and information resources in the process. Orders as we have observed them originate, are negotiated, and are carried out in a dynamically evolving group with fluctuating membership and shifting role responsibilities. Furthermore, orders by themselves represent only a partial picture of what is done for the patient. Conclusions: We argue that information systems are more likely to be helpful if they accommodate and facilitate POE as a multidisciplinary collaboration effort and fit better into the larger system of patient care.

Original languageEnglish (US)
Pages (from-to)376-384
Number of pages9
JournalMethods of Information in Medicine
Issue number4
StatePublished - 2003


  • Computerized physician order entry (CPOE)
  • Distributed cognition
  • Human computer interaction
  • Social informatics

ASJC Scopus subject areas

  • Health Informatics
  • Advanced and Specialized Nursing
  • Health Information Management


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