Research paper - Controlled trial of direct physician order entry: Effectson physicians time utilization in ambulatory primary care internal medicine practices

Objective: Direct physician order entry (POE) offers many potential benefit s, but evidence suggests that POE requires substantially more time than tra ditional paper-based ordering methods. The Medical Gopher is a well-accepte d system for direct POE that has been in use for more than 15 years. The au thors hypothesized that physicians using the Gopher would not spend any mor e time writing orders than physicians using paper-based methods. Design: A randomized controlled trial of POE using the Medical Gopher syste m in 11 primary care internal medicine practices. Measurements: The authors collected detailed time use data using time motio n studies of the physicians and surveyed their opinions about the POE syste m. Results: The authors found that physicians using the Gopher spent 2.2 min m ore 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 pa tient. The survey revealed that the physicians believed that the system imp roved 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 w hile enjoying the many benefits of POE.