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. 2010 Feb;45(1):152-71.
doi: 10.1111/j.1475-6773.2009.01063.x. Epub 2009 Nov 19.

Electronic prescribing at the point of care: a time-motion study in the primary care setting

Emily Beth Devine  1 , William Hollingworth, Ryan N Hansen, Nathan M Lawless, Jennifer L Wilson-Norton, Diane P Martin, David K Blough, Sean D Sullivan
Affiliations

Electronic prescribing at the point of care: a time-motion study in the primary care setting

Emily Beth Devine et al. Health Serv Res. 2010 Feb.

Abstract

Objective: To evaluate the impact of an ambulatory computerized provider order entry (CPOE ) system on the time efficiency of prescribers. Two primary aims were to compare prescribing time between (1) handwritten and electronic (e-) prescriptions and (2) e-prescriptions using differing hardware configurations.

Data sources/study setting: Primary data on prescribers/staff were collected (2005-2007) at three primary care clinics in a community based, multispecialty health system.

Study design: This was a quasi-experimental, direct observation, time-motion study conducted in two phases. In phase 1 (n=69 subjects), each site used a unique combination of CPOE software/hardware (paper-based, desktops in prescriber offices or hallway workstations, or laptops). In phase 2 (n=77), all sites used CPOE software on desktops in examination rooms (at point of care).

Data collection methods: Data were collected using TimerPro software on a Palm device.

Principal findings: Average time to e-prescribe using CPOE in the examination room was 69 seconds/prescription-event (new/renewed combined)-25 seconds longer than to handwrite (99.5 percent confidence interval [CI] 12.38), and 24 seconds longer than to e-prescribe at offices/workstations (99.5 percent CI 8.39). Each calculates to 20 seconds longer per patient.

Conclusions: E-prescribing takes longer than handwriting. E-prescribing at the point of care takes longer than e-prescribing in offices/workstations. Improvements in safety and quality may be worth the investment of time.

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Figures

Figure 1
Figure 1
Major Task Categories, Comparison of Phase 1 with Phase 2 (Aim 4)
Figure 2
Figure 2
Overarching Activity Types for Prescribers and Staff, Proportion of Time Spent (Aim 5)
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