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Impact of computerized physician order entry on physician time
D W Bates1, D L Boyle, J M Teich
1Center for Applied Medical Information Systems Research, Harvard Medical School.
Proceedings. Symposium on Computer Applications in Medical Care
|January 1, 1994
Summary
Computerized physician order entry (CPOE) initially doubled the time housestaff spent writing orders. However, some administrative tasks were streamlined, partially offsetting the increased order entry time.
Area of Science:
- Health Informatics
- Medical Administration
- Clinical Workflow Analysis
Background:
- Traditional physician order writing is time-consuming.
- The implementation of electronic health records aims to improve efficiency.
- Computerized Physician Order Entry (CPOE) is a key component of EHR systems.
Purpose of the Study:
- To evaluate the impact of CPOE on housestaff time allocation.
- To quantify changes in time spent on order writing and associated tasks.
- To identify specific areas of time efficiency gains or losses with CPOE.
Main Methods:
- Utilized time-motion techniques to observe and record housestaff activities.
- Compared time spent on order entry before and after CPOE implementation.
- Segmented analysis by medical and surgical housestaff and order type.
Main Results:
- CPOE significantly increased order writing time (44 min for medical, 73 min for surgical).
- Medical housestaff recovered approximately half the lost time due to eased administrative tasks (e.g., chart retrieval).
- Stereotyped orders were faster with CPOE, but one-time orders took longer.
Conclusions:
- CPOE implementation initially increases direct order writing time for housestaff.
- Efficiency gains in administrative tasks can partially mitigate increased order entry time.
- Strategies are needed to optimize CPOE for non-standardized orders to maximize time savings.