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★ Technology Evaluation ★

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

William Hollingworth, Emily Beth Devine, Ryan N. Hansen, Nathan M. Lawless, Bryan A. Comstock, Jennifer L. Wilson-Norton, Kathleen L. Tharp, Sean D. Sullivan
DOI: http://dx.doi.org/10.1197/jamia.M2377 722-730 First published online: 1 November 2007

Abstract

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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