When they hear the phrase CPOE, most people think big–big cost, big end-user, big implementation. But it’s not necessarily so. Moses Lake Community Health Center (MLCHC) in Moses Lake, Wash., is proof.

MLCHC is a community healthcare facility with two clinic sites and a variety of owned support services such as laboratory, imaging, pharmacy and dental. Fifteen providers (physicians, PA-Cs and ARNPs) and about 170 support staff handle monthly medical encounters totaling about 5,000. Their patient population consists of those with Medicare, Medicaid, private and commercial insurance, plus self-pays and those unable to pay, and the organization is dedicated to giving every patient the same level of high-quality care.

MLCHC began using the Physician Micro Systems Inc. (PMSI) Practice Partner electronic medical record (EMR), Patient Records, in October 2002. Ten months later, the organization relocated all of its paper charts off-site, but it wasn’t done by a long shot.

According to EMR Specialist Carolyn L. Hutchinson, MLCHC’s second step in its planned automation strategy was to implement a computerized physician order entry component. Their primary motivation was, of course, to track orders, particularly lab orders. But their secondary motivation–and rigid requirement–represented a challenge. “We wanted an order entry (OE) system to electronically track referrals, whether they be for an ultrasound, a mammogram, a visit to an orthopedic surgeon or a mental health referral. We saw the ability to do that within the OE component.”