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Controlled Trial of Direct Physician Order Entry: Effects on Physicians' Time Utilization in Ambulatory Primary Care Internal Medicine Practices
Open accessAbstract
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.
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Metadata
- Authors
- Overhage, J. M., Perkins, S., Tierney, W. M., & McDonald, C. J.
- Affiliations
- Regenstrief Institute (US)
- Corresponding author
- Overhage, J. M.
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-07-01
- Volume
- 8
- Issue
- 4
- Pages
- 361-371
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC130081
- OpenAlex
- W1784750808
- Cited by
- 232
- References
- 33
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 3 · 2021: 1 · 2020: 6 · 2019: 6 · 2018: 2 · 2017: 3 · 2016: 7 · 2015: 9 · 2014: 16 · 2013: 14 · 2012: 8
- FWCI
- 34.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. National Library of Medicine (N01-LM-63546, N01-LM43510)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
- Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
- Keywords
- physician time use, internal medicine practice, time and motion study, physician experience, physician attitudes, electronic health records
- MeSH terms
- Attitude of Health Personnel, Attitude to Computers, Data Collection, Decision Making, Computer-Assisted, Hospital Information Systems, Humans, Microcomputers, Time and Motion Studies, Medical Records Systems, Computerized
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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