U.S. hospitals have a long way to go to reach the federal government's proposed standard of entering at least 10 percent of orders electronically, according to a new report from research firm KLAS.

The 2010 report finds that only 14 percent of all U.S. hospitals have achieved the expected 10 percent CPOE level required for stage 1 of meaningful use.

CPOE: Traffic Jams on the Road to Meaningful Use features data gathered from virtually every hospital in the United States (excluding military or Veterans Administration facilities) that was live with a commercial CPOE product through 2009.

"Clearly it is rush hour for hospitals trying to achieve meaningful use," said Jason Hess, KLAS general manager of clinical research and author of the CPOE report. "While some EMR vendors have continued to be very successful moving customers to CPOE, even the market leaders are going to have to run faster than historical adoption trends for their installed bases to receive the earliest possible government reimbursement payments."

Cerner, Eclipsys, Epic lead

As in previous annual reports, Cerner, Eclipsys and Epic continue to lead in CPOE adoption. While Cerner has the most hospitals live with CPOE, Eclipsys and Epic boast the highest percentage of adoption among their respective customer bases.

Client satisfaction at CPOE sites has remained relatively high for these vendors, KLAS reports. The Eclipsys CPOE solution maintains the highest physician satisfaction rating of currently marketed products in the KLAS study, while both Cerner and Epic customers are shown to be more satisfied the more deeply they adopt CPOE.
 
According to the KLAS report, the McKesson and MEDITECH customer bases face a more challenging road, as many of those hospitals are deploying or planning to deploy significant technology upgrades to improve physician adoption. KLAS found that their clients need to roll out CPOE more than 30 times faster than they have in the past year if all are to achieve CPOE adoption before July 1, 2011. Still, both vendors did see a relatively significant increase in the number of live CPOE sites in 2009.
 
Siemens is gaining speed with its Soarian solution. Stuck at just three CPOE sites since 2005, Siemens grew to 10 Soarian hospitals live with CPOE this year. Providers noted that Soarian CPOE works but is still maturing.

Especially tough for small hospitals

The roadblocks to achieving CPOE adoption are even more significant for smaller community hospitals with fewer than 200 beds. Less than 12 percent of community hospitals have adopted CPOE, and those who have show generally shallow adoption, according to KLAS. If all community hospitals were to implement CPOE in time for the earliest possible payment, more than eight of them would need to go live on CPOE every day from June 1, 2010, to July 1, 2011.
 
"I went to one of [my vendor's] user conferences and waited to hear that they are getting their customers to meaningful use levels," KLAS quotes one provider. "I would have liked to hear about facilities that are already successful, but instead, all I heard was their promise that their customers won't get penalized."
 
CPOE: Traffic Jams on the Road to Meaningful Use highlights CPOE solutions from Cerner, CPSI, Eclipsys, Epic, GE, Healthland, HMS, McKesson, MEDITECH, QuadraMed and Siemens.