Literature DB >> 19929963

Electronic prescribing at the point of care: a time-motion study in the primary care setting.

Emily Beth Devine1, William Hollingworth, Ryan N Hansen, Nathan M Lawless, Jennifer L Wilson-Norton, Diane P Martin, David K Blough, Sean D Sullivan.   

Abstract

OBJECTIVE: To evaluate the impact of an ambulatory computerized provider order entry (CPOE ) system on the time efficiency of prescribers. Two primary aims were to compare prescribing time between (1) handwritten and electronic (e-) prescriptions and (2) e-prescriptions using differing hardware configurations. DATA SOURCES/STUDY
SETTING: Primary data on prescribers/staff were collected (2005-2007) at three primary care clinics in a community based, multispecialty health system. STUDY
DESIGN: This was a quasi-experimental, direct observation, time-motion study conducted in two phases. In phase 1 (n=69 subjects), each site used a unique combination of CPOE software/hardware (paper-based, desktops in prescriber offices or hallway workstations, or laptops). In phase 2 (n=77), all sites used CPOE software on desktops in examination rooms (at point of care). DATA COLLECTION
METHODS: Data were collected using TimerPro software on a Palm device. PRINCIPAL
FINDINGS: Average time to e-prescribe using CPOE in the examination room was 69 seconds/prescription-event (new/renewed combined)-25 seconds longer than to handwrite (99.5 percent confidence interval [CI] 12.38), and 24 seconds longer than to e-prescribe at offices/workstations (99.5 percent CI 8.39). Each calculates to 20 seconds longer per patient.
CONCLUSIONS: E-prescribing takes longer than handwriting. E-prescribing at the point of care takes longer than e-prescribing in offices/workstations. Improvements in safety and quality may be worth the investment of time.

Entities:  

Mesh:

Year:  2009        PMID: 19929963      PMCID: PMC2813442          DOI: 10.1111/j.1475-6773.2009.01063.x

Source DB:  PubMed          Journal:  Health Serv Res        ISSN: 0017-9124            Impact factor:   3.402


  31 in total

1.  Overcoming barriers to adopting and implementing computerized physician order entry systems in U.S. hospitals.

Authors:  Eric G Poon; David Blumenthal; Tonushree Jaggi; Melissa M Honour; David W Bates; Rainu Kaushal
Journal:  Health Aff (Millwood)       Date:  2004 Jul-Aug       Impact factor: 6.301

2.  Factors and forces affecting EHR system adoption: report of a 2004 ACMI discussion.

Authors:  Joan S Ash; David W Bates
Journal:  J Am Med Inform Assoc       Date:  2004-10-18       Impact factor: 4.497

3.  Physicians and ambulatory electronic health records.

Authors:  David W Bates
Journal:  Health Aff (Millwood)       Date:  2005 Sep-Oct       Impact factor: 6.301

4.  Primary care physician time utilization before and after implementation of an electronic health record: a time-motion study.

Authors:  Lisa Pizziferri; Anne F Kittler; Lynn A Volk; Melissa M Honour; Sameer Gupta; Samuel Wang; Tiffany Wang; Margaret Lippincott; Qi Li; David W Bates
Journal:  J Biomed Inform       Date:  2004-12-14       Impact factor: 6.317

Review 5.  The impact of electronic health records on time efficiency of physicians and nurses: a systematic review.

Authors:  Lise Poissant; Jennifer Pereira; Robyn Tamblyn; Yuko Kawasumi
Journal:  J Am Med Inform Assoc       Date:  2005-05-19       Impact factor: 4.497

6.  Health information technology and physician-patient interactions: impact of computers on communication during outpatient primary care visits.

Authors:  John Hsu; Jie Huang; Vicki Fung; Nan Robertson; Holly Jimison; Richard Frankel
Journal:  J Am Med Inform Assoc       Date:  2005-03-31       Impact factor: 4.497

7.  The impact of computerized physician order entry on medication error prevention.

Authors:  D W Bates; J M Teich; J Lee; D Seger; G J Kuperman; N Ma'Luf; D Boyle; L Leape
Journal:  J Am Med Inform Assoc       Date:  1999 Jul-Aug       Impact factor: 4.497

8.  The development and evaluation of an integrated electronic prescribing and drug management system for primary care.

Authors:  Robyn Tamblyn; Allen Huang; Yuko Kawasumi; Gillian Bartlett; Roland Grad; André Jacques; Martin Dawes; Michal Abrahamowicz; Robert Perreault; Laurel Taylor; Nancy Winslade; Lise Poissant; Alain Pinsonneault
Journal:  J Am Med Inform Assoc       Date:  2005-12-15       Impact factor: 4.497

9.  Role of computerized physician order entry systems in facilitating medication errors.

Authors:  Ross Koppel; Joshua P Metlay; Abigail Cohen; Brian Abaluck; A Russell Localio; Stephen E Kimmel; Brian L Strom
Journal:  JAMA       Date:  2005-03-09       Impact factor: 56.272

10.  Physician inpatient order writing on microcomputer workstations. Effects on resource utilization.

Authors:  W M Tierney; M E Miller; J M Overhage; C J McDonald
Journal:  JAMA       Date:  1993-01-20       Impact factor: 56.272

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  13 in total

1.  Using the time and motion method to study clinical work processes and workflow: methodological inconsistencies and a call for standardized research.

Authors:  Kai Zheng; Michael H Guo; David A Hanauer
Journal:  J Am Med Inform Assoc       Date:  2011-04-27       Impact factor: 4.497

2.  Electronic prescribing: improving the efficiency and accuracy of prescribing in the ambulatory care setting.

Authors:  Amber Porterfield; Kate Engelbert; Alberto Coustasse
Journal:  Perspect Health Inf Manag       Date:  2014-04-01

Review 3.  Impacts of Operational Failures on Primary Care Physicians' Work: A Critical Interpretive Synthesis of the Literature.

Authors:  Carol Sinnott; Alexandros Georgiadis; John Park; Mary Dixon-Woods
Journal:  Ann Fam Med       Date:  2020-03       Impact factor: 5.166

4.  Perceptions of e-prescribing efficiencies and inefficiencies in ambulatory care.

Authors:  Kate L Lapane; Rochelle K Rosen; Catherine Dubé
Journal:  Int J Med Inform       Date:  2010-11-26       Impact factor: 4.046

5.  Cost-effectiveness of a computerized provider order entry system in improving medication safety ambulatory care.

Authors:  Sara H Forrester; Zsolt Hepp; Joshua A Roth; Heidi S Wirtz; Emily Beth Devine
Journal:  Value Health       Date:  2014-05-05       Impact factor: 5.725

Review 6.  Computerized prescriber order entry in the outpatient oncology setting: from evidence to meaningful use.

Authors:  V Kukreti; R Cosby; A Cheung; S Lankshear
Journal:  Curr Oncol       Date:  2014-08       Impact factor: 3.677

7.  Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies.

Authors:  Joy M Grossman; Dori A Cross; Ellyn R Boukus; Genna R Cohen
Journal:  J Am Med Inform Assoc       Date:  2011-11-18       Impact factor: 4.497

8.  Prescriber and staff perceptions of an electronic prescribing system in primary care: a qualitative assessment.

Authors:  Emily Beth Devine; Emily C Williams; Diane P Martin; Dean F Sittig; Peter Tarczy-Hornoch; Thomas H Payne; Sean D Sullivan
Journal:  BMC Med Inform Decis Mak       Date:  2010-11-19       Impact factor: 2.796

9.  Evaluation of the effect of decision support on the efficiency of primary care providers in the outpatient practice.

Authors:  Kavishwar B Wagholikar; Ronald A Hankey; Lindsay K Decker; Stephen S Cha; Robert A Greenes; Hongfang Liu; Rajeev Chaudhry
Journal:  J Prim Care Community Health       Date:  2014-08-25

10.  Impact of an electronic medication management system on hospital doctors' and nurses' work: a controlled pre-post, time and motion study.

Authors:  Johanna I Westbrook; Ling Li; Andrew Georgiou; Richard Paoloni; John Cullen
Journal:  J Am Med Inform Assoc       Date:  2013-05-28       Impact factor: 4.497

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