PURPOSE: The purpose of this clinical project was to design and implement a computerized provider order entry system. BACKGROUND: Well-designed clinical computer systems can advance best practice and quality decision making, leading to improvements in patient and organizational outcomes. DESCRIPTION OF THE PROJECT: An Orders Design Group composed of clinical nurse specialists (CNSs), staff nurses, and information management personnel was formed. CNSs used competencies in the system sphere to lead the integration of the needs of patients, nurses, and organizations into new technologies. OUTCOME: CNSs facilitated implementation of a collaboratively designed interdisciplinary computerized order entry process. CONCLUSION: Evaluation of the design and implementation process demonstrated greater success with the order entry system under the leadership of CNSs than past initiatives where CNSs were not in leadership roles. IMPLICATIONS FOR NURSING PRACTICE: CNS competencies in designing and implementing innovative system-level solutions are key to clinical information systems design.