Journal of the American Medical Informatics Association, Vol 3, 42-55, Copyright © 1996 by American Medical Informatics Association

ARTICLES

Implementation of physician order entry: user satisfaction and self- reported usage patterns

F Lee, JM Teich, CD Spurr and DW Bates
Department of Psychology, Harvard University, Cambridge, MA, USA.

OBJECTIVES: To evaluate user satisfaction, correlates of satisfaction, and self-reported usage patterns regarding physician order entry (POE) in one hospital. DESIGN: Surveys were sent to physician and nurse POE users from medical and surgical services. RESULTS: The users were generally satisfied with POE (mean = 5.07 on a 1 to 7 scale). The physicians were more satisfied than the nurses, and the medical staff were more satisfied than the surgical staff; satisfaction levels were acceptable (more than 3.50) even in the less satisfied groups. Satisfaction was highly correlated with perceptions about POE's effects on productivity, ease of use, and speed. POE features directed at improving the quality of care were less strongly correlated with satisfaction. The physicians valued POE's off-floor accessibility most, and the nurses valued legibility and accuracy of POE orders most. Some features, such as off-floor ordering, were perceived to be highly useful and reported to be frequently used by the physicians; while other features, such as "quick mode'' ordering and personal order sets, received little self-reported use. CONCLUSIONS: Survey of POE users showed that satisfaction with POE was good. Satisfaction was more correlated with perceptions about POE's effect on productivity than with POE's effect on quality of care. Physicians and nurses constitute two very different types of users, underscoring the importance of involving both physicians and nonphysicians in POE development. The results suggest that development efforts should focus on improving system speed, adding on-line help, and emphasizing quality benefits of POE.

This article has been cited by other articles:

				A. M. Bobb, T. H. Payne, and P. A. Gross Viewpoint: Controversies Surrounding Use of Order Sets for Clinical Decision Support in Computerized Provider Order Entry J. Am. Med. Inform. Assoc., January 1, 2007; 14(1): 41 - 47. [Abstract] [Full Text] [PDF]

				Y. Ko, J. Abarca, D. C. Malone, D. C. Dare, D. Geraets, A. Houranieh, W. N. Jones, W. P. Nichol, G. P. Schepers, and M. Wilhardt Practitioners' Views on Computerized Drug-Drug Interaction Alerts in the VA System J. Am. Med. Inform. Assoc., January 1, 2007; 14(1): 56 - 64. [Abstract] [Full Text] [PDF]

				C. Sicotte, G. Pare, M.-P. Moreault, and A. Paccioni A Risk Assessment of Two Interorganizational Clinical Information Systems J. Am. Med. Inform. Assoc., September 1, 2006; 13(5): 557 - 566. [Abstract] [Full Text] [PDF]

				J. S. Upperman, P. Staley, K. Friend, J. Benes, J. Dailey, W. Neches, and E. S. Wiener The Introduction of Computerized Physician Order Entry and Change Management in a Tertiary Pediatric Hospital Pediatrics, November 1, 2005; 116(5): e634 - e642. [Abstract] [Full Text] [PDF]

				L. Poissant, J. Pereira, R. Tamblyn, and Y. Kawasumi The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review J. Am. Med. Inform. Assoc., September 1, 2005; 12(5): 505 - 516. [Abstract] [Full Text] [PDF]

				R. M. Reichley, T. L. Seaton, E. Resetar, S. T. Micek, K. L. Scott, V. J. Fraser, W. C. Dunagan, and T. C. Bailey Implementing a Commercial Rule Base as a Medication Order Safety Net J. Am. Med. Inform. Assoc., July 1, 2005; 12(4): 383 - 389. [Abstract] [Full Text] [PDF]

				S. S. Lyons, T. Tripp-Reimer, B. A. Sorofman, J. E. DeWitt, B. J. BootsMiller, T. E. Vaughn, and B. N. Doebbeling VA QUERI Informatics Paper: Information Technology for Clinical Guideline Implementation: Perceptions of Multidisciplinary Stakeholders J. Am. Med. Inform. Assoc., January 1, 2005; 12(1): 64 - 71. [Abstract] [Full Text] [PDF]

				C. Delpierre, L. Cuzin, J. Fillaux, M. Alvarez, P. Massip, and T. Lang A systematic review of computer-based patient record systems and quality of care: more randomized clinical trials or a broader approach? Int. J. Qual. Health Care, October 1, 2004; 16(5): 407 - 416. [Abstract] [Full Text] [PDF]

				G. D. Martich, C. S. Waldmann, and M. Imhoff Clinical Informatics in Critical Care J Intensive Care Med, May 1, 2004; 19(3): 154 - 163. [Abstract] [PDF]

				D. W. Bates, G. J. Kuperman, S. Wang, T. Gandhi, A. Kittler, L. Volk, C. Spurr, R. Khorasani, M. Tanasijevic, and B. Middleton Ten Commandments for Effective Clinical Decision Support: Making the Practice of Evidence-based Medicine a Reality J. Am. Med. Inform. Assoc., November 1, 2003; 10(6): 523 - 530. [Abstract] [Full Text] [PDF]

				T. H. Payne, P. J. Hoey, P. Nichol, and C. Lovis Preparation and Use of Preconstructed Orders, Order Sets, and Order Menus in a Computerized Provider Order Entry System J. Am. Med. Inform. Assoc., July 1, 2003; 10(4): 322 - 329. [Abstract] [Full Text] [PDF]

				G. J. Kuperman and R. F. Gibson Computer Physician Order Entry: Benefits, Costs, and Issues Ann Intern Med, July 1, 2003; 139(1): 31 - 39. [Abstract] [Full Text] [PDF]

				M. J. van der Meijden, H. J. Tange, J. Troost, and A. Hasman Determinants of Success of Inpatient Clinical Information Systems: A Literature Review J. Am. Med. Inform. Assoc., May 1, 2003; 10(3): 235 - 243. [Abstract] [Full Text] [PDF]

				D. F. Doolan, D. W. Bates, and B. C. James The Use of Computers for Clinical Care: A Case Series of Advanced U.S. Sites J. Am. Med. Inform. Assoc., January 1, 2003; 10(1): 94 - 107. [Abstract] [Full Text] [PDF]

				F. Lee The Social Costs of Seeking Help Journal of Applied Behavioral Science, March 1, 2002; 38(1): 17 - 35. [Abstract] [PDF]

				C. Lovis, M. K. Chapko, D. P. Martin, T. H. Payne, R. H. Baud, P. J. Hoey, and S. D. Fihn Evaluation of a Command-line Parser-based Order Entry Pathway for the Department of Veterans Affairs Electronic Patient Record J. Am. Med. Inform. Assoc., September 1, 2001; 8(5): 486 - 498. [Abstract] [Full Text] [PDF]

				H. J. Murff and J. Kannry Physician Satisfaction with Two Order Entry Systems J. Am. Med. Inform. Assoc., September 1, 2001; 8(5): 499 - 511. [Abstract] [Full Text] [PDF]

				J. M. Overhage, S. Perkins, W. M. Tierney, and C. J. McDonald Controlled Trial of Direct Physician Order Entry: Effects on Physicians' Time Utilization in Ambulatory Primary Care Internal Medicine Practices J. Am. Med. Inform. Assoc., July 1, 2001; 8(4): 361 - 371. [Abstract] [Full Text] [PDF]

				J. M. Teich, P. R. Merchia, J. L. Schmiz, G. J. Kuperman, C. D. Spurr, and D. W. Bates Effects of Computerized Physician Order Entry on Prescribing Practices Arch Intern Med, October 9, 2000; 160(18): 2741 - 2747. [Abstract] [Full Text] [PDF]

				M. Weiner, T. Gress, D. R. Thiemann, M. Jenckes, S. L. Reel, S. F. Mandell, and E. B. Bass Contrasting Views of Physicians and Nurses about an Inpatient Computer-based Provider Order-entry System J. Am. Med. Inform. Assoc., May 1, 1999; 6(3): 234 - 244. [Abstract] [Full Text] [PDF]

				H. Heathfield, D. Pitty, and R. Hanka Evaluating information technology in health care: barriers and challenges BMJ, June 27, 1998; 316(7149): 1959 - 1961. [Full Text]

				A. L. Valenta and U. Wigger Q-methodology: Definition and Application in Health Care Informatics J. Am. Med. Inform. Assoc., November 1, 1997; 4(6): 501 - 510. [Abstract] [Full Text] [PDF]

				L. H. Harpole, R. Khorasani, J. Fiskio, G. J. Kuperman, and D. W. Bates Automated Evidence-based Critiquing of Orders for Abdominal Radiographs: Impact on Utilization and Appropriateness J. Am. Med. Inform. Assoc., November 1, 1997; 4(6): 511 - 521. [Abstract] [Full Text] [PDF]