Literature DB >> 11418543

Controlled trial of direct physician order entry: effects on physicians' time utilization in ambulatory primary care internal medicine practices.

J M Overhage1, S Perkins, W M Tierney, C J McDonald.   

Abstract

OBJECTIVE: Direct physician order entry (POE) offers many potential benefits, but evidence suggests that POE requires substantially more time than traditional paper-based ordering methods. The Medical Gopher is a well-accepted system for direct POE that has been in use for more than 15 years. The authors hypothesized that physicians using the Gopher would not spend any more time writing orders than physicians using paper-based methods.
DESIGN: A randomized controlled trial of POE using the Medical Gopher system in 11 primary care internal medicine practices. MEASUREMENTS: The authors collected detailed time use data using time motion studies of the physicians and surveyed their opinions about the POE system.
RESULTS: The authors found that physicians using the Gopher spent 2.2 min more per patient overall, but when duplicative and administrative tasks were taken into account, physicians were found to have spent only 0.43 min more per patient. With experience, the order entry time fell by 3.73 min per patient. The survey revealed that the physicians believed that the system improved their patient care and wanted the Gopher to continue to be available in their practices.
CONCLUSIONS: Little extra time, if any, was required for physicians to use the POE system. With experience in its use, physicians may even save time while enjoying the many benefits of POE.

Entities:  

Mesh:

Year:  2001        PMID: 11418543      PMCID: PMC130081          DOI: 10.1136/jamia.2001.0080361

Source DB:  PubMed          Journal:  J Am Med Inform Assoc        ISSN: 1067-5027            Impact factor:   4.497


  30 in total

1.  Comparability of two methods of time and motion study used in a clinical setting: work sampling and continuous observation.

Authors:  P Wirth; L Kahn; G T Perkoff
Journal:  Med Care       Date:  1977-11       Impact factor: 2.983

2.  On line prescribing by computer.

Authors:  J B Donald
Journal:  Br Med J (Clin Res Ed)       Date:  1986-04-05

3.  The Medical Gopher--a microcomputer system to help find, organize and decide about patient data.

Authors:  C J McDonald; W M Tierney
Journal:  West J Med       Date:  1986-12

4.  Prescription-writing with a PC.

Authors:  S I Allen; R S Johannes; C S Brown; D M Kafonek; P S Plexico
Journal:  Comput Methods Programs Biomed       Date:  1986-03       Impact factor: 5.428

5.  The effects of computerized medical records on provider efficiency and quality of care.

Authors:  L E Garrett; W E Hammond; W W Stead
Journal:  Methods Inf Med       Date:  1986-07       Impact factor: 2.176

6.  Direct order entry by physicians in a computerized hospital information system.

Authors:  C G Schroeder; P G Pierpaoli
Journal:  Am J Hosp Pharm       Date:  1986-02

7.  Analysis of the online order entry process in an integrated hospital information system.

Authors:  H Ogura; E Sagara; K Yamamoto; H Furutani; Y Kitazoe; Y Takeda
Journal:  Comput Biol Med       Date:  1985       Impact factor: 4.589

8.  The Regenstrief Medical Record System: a quarter century experience.

Authors:  C J McDonald; J M Overhage; W M Tierney; P R Dexter; D K Martin; J G Suico; A Zafar; G Schadow; L Blevins; T Glazener; J Meeks-Johnson; L Lemmon; J Warvel; B Porterfield; J Warvel; P Cassidy; D Lindbergh; A Belsito; M Tucker; B Williams; C Wodniak
Journal:  Int J Med Inform       Date:  1999-06       Impact factor: 4.046

9.  Blended payment methods in physician organizations under managed care.

Authors:  J C Robinson
Journal:  JAMA       Date:  1999-10-06       Impact factor: 56.272

10.  Computerized display of past test results. Effect on outpatient testing.

Authors:  W M Tierney; C J McDonald; D K Martin; M P Rogers
Journal:  Ann Intern Med       Date:  1987-10       Impact factor: 25.391

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  72 in total

1.  Involving users in the implementation of an imaging order entry system.

Authors:  David M Schuster; Suzanne E Hall; Carole B Couse; Debra S Swayngim; Keith Y Kohatsu
Journal:  J Am Med Inform Assoc       Date:  2003-03-28       Impact factor: 4.497

2.  A cross-site qualitative study of physician order entry.

Authors:  Joan S Ash; Paul N Gorman; Mary Lavelle; Thomas H Payne; Thomas A Massaro; Gerri L Frantz; Jason A Lyman
Journal:  J Am Med Inform Assoc       Date:  2003 Mar-Apr       Impact factor: 4.497

3.  A usability study of physicians interaction with a paper-based patient record system and a graphical-based electronic patient record system.

Authors:  Nestor J Rodriguez; Viviam Murillo; José A Borges; Johanna Ortiz; Daniel Z Sands
Journal:  Proc AMIA Symp       Date:  2002

4.  A conceptual framework for evaluating outpatient electronic prescribing systems based on their functional capabilities.

Authors:  Douglas S Bell; Shan Cretin; Richard S Marken; Adam B Landman
Journal:  J Am Med Inform Assoc       Date:  2003-10-05       Impact factor: 4.497

5.  Web-based physician order entry: an open source solution with broad physician involvement.

Authors:  John Windle; Glen Van-Milligan; Sean Duffy; James McClay; James Campbell
Journal:  AMIA Annu Symp Proc       Date:  2003

6.  Using adaptive turnaround documents to electronically acquire structured data in clinical settings.

Authors:  Paul G Biondich; Vibha Anand; Stephen M Downs; Clement J McDonald
Journal:  AMIA Annu Symp Proc       Date:  2003

7.  A proposal for electronic medical records in U.S. primary care.

Authors:  David W Bates; Mark Ebell; Edward Gotlieb; John Zapp; H C Mullins
Journal:  J Am Med Inform Assoc       Date:  2003 Jan-Feb       Impact factor: 4.497

8.  The use of computers for clinical care: a case series of advanced U.S. sites.

Authors:  David F Doolan; David W Bates; Brent C James
Journal:  J Am Med Inform Assoc       Date:  2003 Jan-Feb       Impact factor: 4.497

9.  Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality.

Authors:  David W Bates; Gilad J Kuperman; Samuel Wang; Tejal Gandhi; Anne Kittler; Lynn Volk; Cynthia Spurr; Ramin Khorasani; Milenko Tanasijevic; Blackford Middleton
Journal:  J Am Med Inform Assoc       Date:  2003-08-04       Impact factor: 4.497

10.  Immediate benefits realized following implementation of physician order entry at an academic medical center.

Authors:  Hagop S Mekhjian; Rajee R Kumar; Lynn Kuehn; Thomas D Bentley; Phyllis Teater; Andrew Thomas; Beth Payne; Asif Ahmad
Journal:  J Am Med Inform Assoc       Date:  2002 Sep-Oct       Impact factor: 4.497

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