# Assessing the Relationship between Care Processes and Clinical Decision Support for Order Entry

> **NIH AHRQ R03** · WEILL MEDICAL COLL OF CORNELL UNIV · 2020 · $33,195

## Abstract

Project Summary
 Order sets are a CDS function which presents multiple orders for a particular clinical purpose as a set
(such as an `Admission Order Set') for clinicians to select2. Order sets are expected to improve patient safety
by reducing prescribing variations and errors, and also facilitate efficient order placement based on best
practices and guidelines4,5. The creation of order sets has been considered a requirement for a successful
CPOE implementation2,5,6. However, the association among order sets, their expected benefits, and barriers for
their usage, is understudied.4,7,8 The goal of this pilot study is twofold. First, we will identify potential scenarios
where the use of order sets leads to better outcomes than non-use of order sets, specifically opioid prescribing,
by applying advanced data analytics to historical data. Data on order placement are extracted from electronic
health records (EHR). In parallel, we will use a survey method to understand perceptions on order sets, in
order to remove barriers to the use of this CDS tool which are often reported to not be utilized to its maximum
benefit. In particular, we are interested in the role of order sets in the prescription of opioid medications during
patients inpatient and emergency room (ER) visits. Our overarching hypothesis for this project is that order set
use is associated with improved quality of care (i.e., fewer unexplained variations in care, and reduced opioid
prescribing overall), yet clinician-level barriers are limiting uptake of this CDS modality. Analyses will be
conducted on ordering data from the Department of Internal Medicine, Surgery, and Emergency Medicine. In
Aim 1, we will assess the relationship between order set use and care variation within Internal Medicine,
Surgery, and Emergency Medicine, respectively, while controlling for principal diagnoses, patient complexity,
and campus locations. We hypothesize that more frequent use of order sets is associated with reduced care
variations while controlling for principal diagnoses, patient complexity, and campus locations. In Aim 2, we will
compare the number of opioids prescribed from order sets and prescribed as standalone orders. We
hypothesize that more frequent use of order sets is associated with reduced opioid prescriptions while
controlling for principal diagnoses, patient complexity, and campus locations. In Aim 3, a survey will be
conducted with Internal Medicine, Surgery, and Emergency Medicine clinicians in 3 campuses associated with
NYP Hospital. We hypothesize that trust and self-efficacy about order sets are associated with an increased
order set use while controlling for satisfaction, level of experience, IT training, department, and campus
location. Findings from this study may lay the groundwork for prospective large-scale and interventional studies
to strategize safe and efficient opioid prescriptions through order sets that have sufficient clinician uptake.

## Key facts

- **NIH application ID:** 10002228
- **Project number:** 5R03HS026266-02
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Yiye Zhang
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $33,195
- **Award type:** 5
- **Project period:** 2019-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10002228

## Citation

> US National Institutes of Health, RePORTER application 10002228, Assessing the Relationship between Care Processes and Clinical Decision Support for Order Entry (5R03HS026266-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10002228. Licensed CC0.

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