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Related Experiment Videos

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

W M Tierney1, M E Miller, J M Overhage

  • 1Department of Medicine, Indiana University School of Medicine, Indianapolis.

JAMA
|January 20, 1993
PubMed
Summary

Implementing a microcomputer workstation system for inpatient orders significantly reduced patient charges and hospital costs by 12.7%. While this electronic order entry system saved millions, it did require more physician time for order writing.

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Area of Science:

  • Health Informatics
  • Health Services Research
  • Clinical Operations

Background:

  • Traditional paper-based systems for inpatient orders are prone to errors and inefficiencies.
  • Electronic order entry systems aim to improve patient care and reduce healthcare costs.

Purpose of the Study:

  • To evaluate the impact of a microcomputer workstation network for inpatient order writing on healthcare resource utilization.
  • To assess changes in patient charges and hospital costs associated with implementing an electronic order entry system.

Main Methods:

  • A randomized controlled trial was conducted on an internal medicine service at an urban public hospital.
  • The study involved 5219 patients and 68 healthcare teams, comparing microcomputer workstations linked to an electronic medical record system against standard paper orders.

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  • Outcome measures included total inpatient charges, specific order category charges, and a time-motion study of intern ordering time.

    • Main Results:

    • The intervention group using microcomputer workstations had 12.7% lower charges per admission ($887 reduction; P = .02).
    • Significant reductions were observed in bed, diagnostic test, and drug charges, leading to comparable reductions in hospital costs.
    • Physicians using the electronic system spent significantly more time writing orders (33 minutes longer per 10-hour shift; P < .0001).

    Conclusions:

    • A network of microcomputer workstations for inpatient orders effectively reduced patient charges and hospital costs, with potential for substantial nationwide savings.
    • The system's increased physician time requirement necessitates further research and system advancements to optimize efficiency.
    • Implementation of electronic order entry systems shows promise for cost reduction in healthcare settings.