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Four issues with order sets (and how informatics teams can fix them)
Order sets are meant to standardize care and improve efficiency. And while the intent is good, several issues can arise that impede effectiveness and potentially impact patient care.
Four issues with order sets (and how informatics teams can fix them)
Our recent research showed the impacts of follow-on orders on system operations and patient care. In our webinar, Drs. Marc Tobias and Naveen Muthu discussed the research and outlined four problems with managing order sets—and what informatics teams can do to improve them.
🎬 Watch the discussion: The impact of follow up orders on clinical standardization
Problem 1: Content becomes outdated quickly
The medical landscape is constantly evolving, with new research, guidelines, and best practices emerging regularly. Order sets can quickly become outdated, leading to substandard—or possibly unsafe—care for patients, and a loss of trust in your carefully curated systems. Clinicians develop workarounds to order sets that are known to contain incorrect information. Worse yet, they unknowingly implement suboptimal treatments.
What to do about it: Establish a robust and ongoing maintenance process for order sets that involves subject matter experts who continuously review content. Ideally, leverage clinical evidence gap analysis automation tools to compare existing order sets to the newest evidence.
💡 Pro tip from Dr. Tobias: Be sure to implement version control to track changes and document decision making. This will ensure that institutional knowledge remains intact as staff turns over in an organization.
Problem 2: Inconsistent use among end-users
Even the best evidence-backed order sets can fail if they are rarely used. This inconsistency can stem from various factors, including lack of training, perceived inefficiency, or simply a resistance to change. Clinicians who aren’t adequately trained on the EHR, or who view existing order sets as cumbersome or time-consuming, will be less likely to correctly use the order sets in the first place.
What to do about it: Invest in comprehensive training programs for all users. Clearly communicate the benefits of using order sets and involve clinicians in the development and refinement process to foster ownership and buy-in. Automate the monitoring of usage patterns and address any barriers to compliance.
💡 Pro tip from Dr. Muthu: Consider incorporating order set adoption as part of an incentive program.
Problem 3: Lack of flexibility leads to workarounds
Every patient is unique, with different comorbidities, allergies, and individual needs. Rigid order sets can make it difficult for clinicians to tailor care appropriately, leading to suboptimal patient care and increased frustration and burden on clinicians. Healthcare providers will make up their own workarounds if they’re frustrated by the system leading to variation risks and unnecessary extra clicks.
What to do about it: Review EHR order set data to understand how they interact with your order sets; don’t assume you know! Our Orders within Five Minutes metric can provide a benchmark for understanding when and why clinicians add orders outside of order sets.
💡 Pro tip from Dr. Tobias: Get feedback! Ideally you can go to the bedside and observe how clinicians interact with the EHR in their natural environment. As a substitute, embed feedback surveys into the order sets to asynchronously identify malfunctions. This data can then inform how you redesign order sets to match clinician workflows.
Problem 4: Poorly designed order sets can encourage "click-through" mentalities
Overly comprehensive order sets can lead to an overwhelming user experience. Oftentimes, very long order sets have large sections which are not relevant to the patient in front of them. This can lead to desensitization and ironically increase the cognitive load. While the consensus in the conference room makes sense on paper, it doesn’t align with the end user's clinical workflow.
What to do about it: Monitor engagement with order set orders to evaluate if they are being placed as expected within the corresponding patient population.
💡 Pro tip from Dr. Tobias: The Orders within Five Minutes metric can highlight subsequent orders that may actually be within the order set.
By recognizing and proactively addressing these common problems, healthcare organizations can maximize the standardization benefits of order sets while minimizing their potential drawbacks, ultimately leading to improved patient safety and more efficient, high-quality care.
Start optimizing your order sets today. Request a demo of Phrase Health.
Order sets are meant to standardize care and improve efficiency. And while the intent is good, several issues can arise that impede effectiveness and potentially impact patient care.
Written by
Nov 11, 2025
Written by
Nov 11, 2025
Our recent research showed the impacts of follow-on orders on system operations and patient care. In our webinar, Drs. Marc Tobias and Naveen Muthu discussed the research and outlined four problems with managing order sets—and what informatics teams can do to improve them.
🎬 Watch the discussion: The impact of follow up orders on clinical standardization
Problem 1: Content becomes outdated quickly
The medical landscape is constantly evolving, with new research, guidelines, and best practices emerging regularly. Order sets can quickly become outdated, leading to substandard—or possibly unsafe—care for patients, and a loss of trust in your carefully curated systems. Clinicians develop workarounds to order sets that are known to contain incorrect information. Worse yet, they unknowingly implement suboptimal treatments.
What to do about it: Establish a robust and ongoing maintenance process for order sets that involves subject matter experts who continuously review content. Ideally, leverage clinical evidence gap analysis automation tools to compare existing order sets to the newest evidence.
💡 Pro tip from Dr. Tobias: Be sure to implement version control to track changes and document decision making. This will ensure that institutional knowledge remains intact as staff turns over in an organization.
Problem 2: Inconsistent use among end-users
Even the best evidence-backed order sets can fail if they are rarely used. This inconsistency can stem from various factors, including lack of training, perceived inefficiency, or simply a resistance to change. Clinicians who aren’t adequately trained on the EHR, or who view existing order sets as cumbersome or time-consuming, will be less likely to correctly use the order sets in the first place.
What to do about it: Invest in comprehensive training programs for all users. Clearly communicate the benefits of using order sets and involve clinicians in the development and refinement process to foster ownership and buy-in. Automate the monitoring of usage patterns and address any barriers to compliance.
💡 Pro tip from Dr. Muthu: Consider incorporating order set adoption as part of an incentive program.
Problem 3: Lack of flexibility leads to workarounds
Every patient is unique, with different comorbidities, allergies, and individual needs. Rigid order sets can make it difficult for clinicians to tailor care appropriately, leading to suboptimal patient care and increased frustration and burden on clinicians. Healthcare providers will make up their own workarounds if they’re frustrated by the system leading to variation risks and unnecessary extra clicks.
What to do about it: Review EHR order set data to understand how they interact with your order sets; don’t assume you know! Our Orders within Five Minutes metric can provide a benchmark for understanding when and why clinicians add orders outside of order sets.
💡 Pro tip from Dr. Tobias: Get feedback! Ideally you can go to the bedside and observe how clinicians interact with the EHR in their natural environment. As a substitute, embed feedback surveys into the order sets to asynchronously identify malfunctions. This data can then inform how you redesign order sets to match clinician workflows.
Problem 4: Poorly designed order sets can encourage "click-through" mentalities
Overly comprehensive order sets can lead to an overwhelming user experience. Oftentimes, very long order sets have large sections which are not relevant to the patient in front of them. This can lead to desensitization and ironically increase the cognitive load. While the consensus in the conference room makes sense on paper, it doesn’t align with the end user's clinical workflow.
What to do about it: Monitor engagement with order set orders to evaluate if they are being placed as expected within the corresponding patient population.
💡 Pro tip from Dr. Tobias: The Orders within Five Minutes metric can highlight subsequent orders that may actually be within the order set.
By recognizing and proactively addressing these common problems, healthcare organizations can maximize the standardization benefits of order sets while minimizing their potential drawbacks, ultimately leading to improved patient safety and more efficient, high-quality care.
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