The Impact of e-Prescribing on Prescriber and Staff Time in Ambulatory Care Clinics: A Time-Motion Study

Department of Health Services, University of Washington Seattle, Seattle, Washington, United States
Journal of the American Medical Informatics Association (Impact Factor: 3.5). 08/2007; 14(6):722-30. DOI: 10.1197/jamia.M2377
Source: PubMed


Electronic prescribing has improved the quality and safety of care. One barrier preventing widespread adoption is the potential detrimental impact on workflow. We used time-motion techniques to compare prescribing times at three ambulatory care sites that used paper-based prescribing, desktop, or laptop e-prescribing. An observer timed all prescriber (n = 27) and staff (n = 42) tasks performed during a 4-hour period. At the sites with optional e-prescribing >75% of prescription-related events were performed electronically. Prescribers at e-prescribing sites spent less time writing, but time-savings were offset by increased computer tasks. After adjusting for site, prescriber and prescription type, e-prescribing tasks took marginally longer than hand written prescriptions (12.0 seconds; -1.6, 25.6 CI). Nursing staff at the e-prescribing sites spent longer on computer tasks (5.4 minutes/hour; 0.0, 10.7 CI). E-prescribing was not associated with an increase in combined computer and writing time for prescribers. If carefully implemented, e-prescribing will not greatly disrupt workflow.

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Available from: Ryan N Hansen, Jun 17, 2014
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    • "Although eRx resulted in more time spent on the computer, less time was spent writing. Workflow was not disrupted and eRx was used over 75% of the time (Hollingworth et al., 2007). Bramble et al. (2013) "
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    ABSTRACT: PurposeThe purpose of this study was to review legislation, barriers and challenges, and current state of e-prescribing (eRx) in the United States.Data sourcesLiterature search of CINAHL, MEDLINE, PubMed, and Google Scholar was performed.Conclusions Challenges to eRx implementation and effective use include transcription, workflow issues, alert fatigue, educational and tangible reminders, and eRx of controlled substances.Implications for practiceFurther research could be best focused on user-friendly and interactive software improvements for both patient and provider use, bidirectional communication, and workflow studies to improve efficiency of eRx.
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    • "psychological) [12,26,42,43], consult room layout [42] and patients' ability to schedule appointments [27,33]. For net benefits, care quality factors covered patient safety [38], care effectiveness [40], quality improvement [45] and guideline compliance [32,57,60,61]. Productivity factors covered care efficiency [13,27,38,42,56], coordination [24,58] and net cost including billing, staffing and maintenance costs [25,45,46,52]. "
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    Full-text · Article · Feb 2012 · BMC Medical Informatics and Decision Making
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    • "Most asthmatic patients were unable to use their inhaler correctly. Education on inhalation technique and using inhaler by a spacer equally enhanced the efficacy of inhaler drugs.31 Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of the best practice.32 "
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