Controlled trial of direct physician order entry: effects on physicians' time utilization in ambulatory primary care internal medicine practices

• HIT Description: Locally developed system called Medical Gopher. The Gopher provides order entry, clinical documentation, diagnostic result review, access to clinical knowledge bases, and links to billing functions. Order entry. More info...
  
• Purpose of Study: Assess physical time associated with direct order entry
  
• Years of study: 1996-1998
  
• Study Design: RCT
  
• Outcomes: Time spent on tasks
  

• Settings: This study was performed in primary care practices that are part of the Indiana University Medical Group.
• Evaluation Method: Prior to the study, all providers hand wrote patient notes on encounter forms that were generated specifically for each patient by the Regenstrief Medical Record System (RMRS.) The study was a randomized, controlled trial of the Medical Gopher system. Full time Internists were randomized at the practice level into the intervention group or the control.
• Quality of Care and Patient Safety Outcome: Intervention physicians were also surveyed and they rated that their work was done faster, easier, that the quality of documentation improved, workflow was improved, and quality of care was improved when using the Gopher system.
• Changes in efficiency and productivity: Time spent on tasks was assessed using a time and motion study. The study reported that the number of minutes spent per patient averaged 35.8 in the intervention group (direct order entry) and 34.2 in the control group. The study reported that with experience the direct order entry time fell by 3.73 minutes per patient.