Physician characteristics, attitudes, and use of computerized order entry

Authors

  • Peter K. Lindenauer MD, MSc,

    Corresponding author
    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
    2. Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
    • Division of Healthcare Quality, Baystate Medical Center, 759 Chestnut Street P-5928, Springfield MA 01199; Fax: (413) 794-8866
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    • Peter Lindenauer, MD, MSc, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • David Ling MD,

    1. Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
    2. Division of General Medicine and Geriatrics, Baystate Medical Center, Springfield, Massachusetts
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  • Penelope S. Pekow PhD,

    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
    2. School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
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  • Allison Crawford BA,

    1. School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
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  • Deborah Naglieri-Prescod PhD,

    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
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  • Nancy Hoople MPH,

    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
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  • Janice Fitzgerald MS, RN,

    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
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  • Evan M. Benjamin MD

    1. Division of Healthcare Quality, Baystate Medical Center, Springfield, Massachusetts
    2. Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts
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Abstract

BACKGROUND

Computerized physician order entry (CPOE) is a widely advocated patient safety intervention, yet little is known about its adoption by attending physicians or community hospitals.

METHODS

We calculated the order entry rates of attending physicians at 2 hospitals by measuring the number of orders entered directly and dividing this by the sum of orders entered directly and those written by hand. These findings were paired with the results of a survey that assessed attitudes concerning the impact of CPOE on personal efficiency, quality of care, and patient safety.

RESULTS

Three hundred and fifty-six (71%) of the 502 surveys were returned by physicians, whose median order entry rate was 66%. Forty-two percent of respondents placed at least 80% of their orders electronically (high use), 26% placed 21%-79% of their orders electronically (intermediate use), and 32% placed 20% or less of their orders electronically (low use). Sex, years since medical school graduation, years in practice at the study institution, and use of computers in the outpatient arena were not meaningfully different among the 3 groups. However, use of the system to place orders varied by specialty, and those with intermediate or high use of the system were more likely than low users to have used CPOE during training and to be regular users of computers for personal activities. These physicians were more likely to believe that CPOE enabled orders to be placed efficiently, that directly entered orders were carried out more rapidly, and that such orders were associated with fewer errors.

CONCLUSIONS

The adoption of CPOE by attending physicians at community hospitals varies widely. In addition to purchasing systems that support physician work flow, hospitals intent on successfully implementing CPOE should emphasize the benefits in safety and quality of this new technology. Journal of Hospital Medicine 2006;1:221–230. © 2006 Society of Hospital Medicine.

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