Workflow, Time Requirement, and Quality of Medication Documentation with or without a Computerized Physician Order...

Area of Science:

• Health Informatics
• Clinical Workflow Analysis
• Medication Management

Background:

• Computerized Physician Order Entry (CPOE) systems are transforming healthcare by altering professional workflows and task distribution.
• Understanding the impact of CPOE on medication documentation is crucial for optimizing healthcare delivery.

Purpose of the Study:

• To analyze workflow modifications resulting from CPOE implementation.
• To quantify the time expenditure for medication documentation with and without CPOE.
• To assess the quality of medication documentation pre- and post-CPOE integration.

Main Methods:

• Workflow assessment via direct observation, in-person interviews, and online surveys.
• Development of two case scenarios with 6 and 11 medications, respectively.
• Measurement of documentation time for physicians and nurses/assistants before and after CPOE implementation.
• Evaluation of documentation quality using a standardized methodology.

Main Results:

• CPOE implementation simplified the documentation process.
• Overall medication documentation time increased by 20% (median 12:12 min to 14:40 min, p=0.002).
• Documentation quality significantly improved from 66.7% to 100% (p<0.001), with increased time for IV/SC prescriptions.
• Physician documentation time doubled, while nurses experienced time savings.

Conclusions:

• CPOE enhances medication documentation quality but increases overall time, particularly for physicians and complex prescriptions.
• Workflow adjustments and targeted support for physicians using CPOE are necessary.
• Further research should focus on optimizing CPOE for complex medication orders.