Research paper - Controlled trial of direct physician order entry: Effects on physicians time utilization in ambulatory primary care internal medicine practices
Research paper - Controlled trial of direct physician order entry: Effects on physicians time utilization in ambulatory primary care internal medicine practices
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DOI：
10.1136/jamia.2001.0080361
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发表时间：
2001-07-01
影响因子：
6.4
通讯作者：
McDonald, CJ
中科院分区：
文献类型：
--
作者：
Overhage, JM;Perkins, S;McDonald, CJ
目的：直接医嘱输入（POE）提供了许多潜在的好处，但有证据表明，POE需要更多的时间比传统的基于纸张的订购方法。Medical Gopher是一种广泛接受的直接POE系统，已使用超过15年。作者假设使用Gopher的医生不会比使用纸质方法的医生花费更多的时间来写医嘱。设计：在11个初级保健内科实践中使用Medical Gopher系统进行POE的随机对照试验。测量：作者使用时间运动研究收集了医生的详细时间使用数据，并调查了他们对POE系统的意见。结果：作者发现，使用Gopher的医生在每位患者身上多花了2.2分钟，但当考虑到重复和管理任务时，医生在每位患者身上只多花了0.43分钟。根据经验，每位患者的订单输入时间缩短了3.73分钟。调查显示，医生认为，该系统改善了他们的病人护理，并希望继续在他们的practice.Conclusions：一点额外的时间，如果有的话，需要医生使用TOE系统。凭借其使用经验，医生甚至可以节省时间，同时享受POE的许多好处。
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 TOE system. With experience in its use, physicians may even save time while enjoying the many benefits of POE.