The adoption of Computerized Physician Order Entry (CPOE) systems represents a significant advancement in healthcare, offering numerous benefits such as improved medication safety, streamlined workflows, and enhanced patient outcomes. Despite these advantages, widespread and consistent use by physicians remains a challenge. Understanding the multifaceted factors that influence physicians’ actual use of CPOE systems is essential for optimizing their implementation and maximizing their potential to transform clinical practice.
While many studies focus on the initial adoption phase, this review delves into the ongoing usage behaviors of physicians after the system has been installed. It aims to identify the individual, organizational, and technological determinants that affect how physicians interact with CPOE for medication prescribing. Recognizing these factors can inform targeted strategies to improve system usability, acceptance, and ultimately, patient safety.
This systematic review synthesizes evidence from diverse research designs, including qualitative, quantitative, and mixed-methods studies, to provide a comprehensive understanding of what drives or hinders physicians’ engagement with CPOE systems. The findings are contextualized within established theoretical frameworks, such as the unified theory of acceptance and use of technology (UTAUT) and the Delone and McLean Information System Success Model, offering a structured approach to interpret the complex landscape of health technology utilization.
The importance of this research extends beyond individual clinicians, influencing organizational policies and system design choices. By highlighting the core factors—including perceptions of system usefulness, ease of use, organizational support, and technical reliability—stakeholders can tailor interventions that foster sustained and effective system use. For example, integrating insights from industry support how is ai helping in the healthcare industry can aid in developing smarter, AI-enhanced decision support tools that resonate with physicians’ workflows.
The review also uncovers specific technological attributes, such as system speed, customization options, and the relevance of alerts, which significantly impact usage. These findings align with prior research emphasizing that technological quality and information relevance are critical for user satisfaction and system efficiency. For further understanding of how health systems vary across North America, the north american models how does canadas healthcare system work offers valuable context on regional differences that may influence system adoption.
In addition, organizational factors such as adequate training, technical support, and resource availability are repeatedly identified as facilitators of sustained use. Addressing time constraints and reducing complexity can alleviate physician frustration and promote more consistent engagement with CPOE. Incorporating these insights can help healthcare institutions design more user-centered systems that align with clinicians’ needs.
Despite technological advancements, challenges such as alert fatigue—where excessive warnings lead to dismissal of safety alerts—still affect system utilization. Interestingly, some studies suggest that alert fatigue may not be as pervasive as initially thought, emphasizing the need for tailored alert systems that balance safety with usability. Customizing CPOE features according to departmental needs, like ICU-specific alerts, enhances relevance and reduces cognitive load, further encouraging use.
The integration of these findings within the UTAUT and Delone and McLean models provides a robust framework for understanding the interplay between individual perceptions, organizational readiness, and system attributes. This comprehensive perspective underscores that successful implementation extends beyond technical deployment; it requires ongoing attention to user experience and contextual factors.
However, limitations remain. The review’s scope was confined to four major databases, possibly missing relevant studies from other sources. Additionally, most research originates from developed countries, highlighting a gap in understanding how cultural and systemic differences in developing nations influence CPOE usage. Future work should explore these contextual nuances to develop globally applicable strategies.
In conclusion, enhancing physicians’ engagement with CPOE systems depends on addressing perceptions of usefulness and ease of use, ensuring organizational support, and optimizing technological design. Recognizing the specific factors that influence actual usage can guide system developers, healthcare managers, and policymakers in creating environments that foster sustainable and effective use of health information technology. Through such targeted efforts, healthcare systems can better realize the full potential of CPOE to improve medication safety and patient care.
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